Attachment E -- Consumer or Patient Repondent Materials

Attachment E

Consumer or Patient Respondent Materials

Consumer Survey Advance Letter

{Date}

{FirstName}{LastName}

{Address1}

{City} {State} {Zip}

Dear {FirstName}{LastName}:

The Agency for Healthcare Research and Quality (AHRQ) is sponsoring a study about health care services in the United States. The purpose of the study is to better understand how people work with their health care providers to make decisions about the best medical treatments for their medical situation. IMPAQ International, LLC is a private research company that specializes in research on health care services. We are working with the Federal government to conduct the study.

We would like to contact you and conduct a brief telephone interview. The interview will ask about your personal experiences working with health care providers (like doctors, nurses, and other medical personnel) and your role in making decisions about your health care treatments. The interview takes about 20 minutes to complete.

In the next few weeks, an interviewer from IMPAQ International will call you to arrange a convenient time to conduct the interview. Your participation is voluntary and you may refuse to answer any questions or terminate the interview at any time. Your answers will be kept confidential to the extent permitted by law, including AHRQ’s confidentiality statute, 42 USC 299c-3(c). You will never be personally identified in any report based on the survey. No one will attempt to sell you anything or ask for a donation because you participated in this study.

If you have any questions or would like to set up an appointment to complete the interview, please call us toll-free at 1-877-367-0088.

Thank you in advance for your participation. Your input is critical to the success of the study. We look forward to speaking with you soon.

Sincerely,

Sari Siegel

Project Director

Non-response Follow-up Letter

{Date}

{FirstName}{LastName}

{Address1}

{City} {State} {Zip}

Dear {FirstName}{LastName}:

We need your help! We have been trying to reach you to complete a brief interview for an important study about health care sponsored by the Agency for Healthcare Quality and Research (AHRQ).

Unfortunately, we have been unable to reach by telephone to complete the interview. The interview takes about 20 minutes to complete. We can schedule a convenient time for the interview and if necessary you can complete the interview in more than one call. If you would prefer to call us we can be reached toll free at 1-XXX-XXX-XXXX.

Thank you in advance for your participation. Your input is critical to the success of the study. We look forward to speaking with you soon.

Sincerely,

Sari Siegel

Project Director

Consumer Survey Thank-You Letter

{Date}

{FirstName}{LastName}

{Address1}

{City} {State} {Zip}

Dear {FirstName}{LastName}:

Thank you for your recent participation in an interview about health care services. Your input was invaluable to the study, and the information you provided will help the Federal government improve the quality of health care in the United States.

Thank you again for your participation. Your input was critical to the success of the study.

Sincerely,

Sari Siegel

Project Director

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