SASH First Mailing

^{Sample Cover Letter for} First Questionnaire Mailing

SASH Panel Survey

NAME [PRINT SAMPLE IDENTIFICATION NUMBER HERE]

ADDRESS

CITY, STATE ZIP

Dear NAME:

The Federal government is interested in programs that seek to improve the quality of life and health of indivduals living in affordable congregate housing by providing coordinated health and supportive services in government subsidized buildings. The Department of Housing and Urban Development (HUD), the Assistant Secretary for Planning and Evaluation (ASPE) and the Administration on Aging (AoA) at the Department of Human Services has contracted with non-profit research company RTI International to conduct a survey to learn more about your health and personal experiences. Your name was selected at random from among Medicare beneficiaries residing at [BUILDING NAME].

We would greatly appreciate it if you would take about 20 minutes to fill out the survey. The results of this survey will be used to improve the quality of services that Medicare beneficiaries like you receive.

All information that would let someone identify you or your family will be kept private. RTI International will not share your personal information with anyone. Your responses to this survey are also private to the extent permitted by law. Your individual answers will never be seen by your doctors or anyone else involved with your care. You may notice a number on the cover of the survey. This number is used only to let us know if you returned your survey so we don’t have to send you reminders.

You may choose to answer this survey or not. Your decision will not affect the health care you receive. Once you complete the survey, place it in the return envelope that was provided, seal the envelope, and mail the envelope to RTI International.

If you have any questions about this survey, please call Ellen Stutts toll free at 1-800-###-####. If you have any questions about your rights as a survey respondent, you may call RTI's Office of Research Protection toll-free at 1-866-214-2043.

Thank you in advance for your participation.

Sincerely,

Nancy McCall, RN, Sc.D.

SASH Project Director

RTI International

Nota: Si quiere una encuesta en español, por favor llame al (800) 247-6056.

Enclosures