Form Approved
OMB No. 0920-0572
Exp. Date XX/XX/XXXX
SCRIPT: INVITATION FOR ELIGIBLE PARTICIPANTS
INVITATION FOR ELIGIBLE PARTICIPANTS
READ: “We want to invite you to be in an interview about HIV-related materials under development. We will get together for about an hour to get your opinions on these materials, which might include a PSA, billboard, brochure or other advertisement. We will be audio-recording the interview.
If you choose to attend, whatever you say will be kept private to the extent allowable by law. You will be given a $40 gift card. If you are more than 60 minutes late for the interview, you may be rescheduled for another day or time.
In a minute, I will need to ask you for your first name and phone number so that we can call to remind you about the appointment. This information is necessary for you to take part. All of your contact information will be destroyed immediately after the interview.”
READ: May I schedule you to come?
Yes |
Confirm the date and time of the interview, and give the address of the interview and directions. |
No |
READ: “If you decide that you want to attend, please call us at [insert phone number]. Thank you for your time.” |
Don’t Know / Not Sure / Declines to answer |
READ: “If you decide that you want to attend, please call us at [insert phone number]. Thank you for your time.” |
READ: “May I have your first name?”
NAME: _____________________________________________________________
READ: “A day or so before your appointment, we will call you to re-confirm the time. We will need your phone number to do this. What is the best time to reach you? What is the best telephone number to reach you at that time?”
BEST TIME TO BE REACHED: _______________________________________________
BEST PHONE NUMBER: _______________
READ: “Is there another time and number we can try if we miss you?”
ALTERNATE TIME TO BE REACHED: _________________________________________
ALTERNATE PHONE NUMBER: __
READ: Can we leave a message? We will not leave any details in the message, but will remind you of the appointment and ask you to call us back to confirm.” __ Yes ____ No____
READ: “Your participation in this project is very important. If for some reason you will not be able to attend, please let us know right away. You can call us anytime at [insert phone number], and if we are not here, please leave a message. Thank you.”
To be completed by recruiter |
||
Eligible and scheduled – NOTE TIME/DATE/LOCATION
|
YES |
NO |
Eligible, but not scheduled: NOTE REASON |
YES |
NO |
Eligible, but refused to participate: NOTE REASON |
YES |
NO |
Ineligible |
YES |
NO |
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | uyy6 |
File Modified | 0000-00-00 |
File Created | 2021-01-25 |