Intro and Consent Form

[INTRODUCTION AND CONSENT]

Thank you for participating in this survey. Your opinions are very important to us.

The US Food and Drug Administration (FDA) is conducting a research study to gain a better understanding of how consumers understand communications about medicines.

In this survey, we will ask you to review some written materials about a drug that appear on a website, and then to answer questions about the communication. Your responses will be kept strictly confidential. Results will be reported in aggregate form only for all respondents. We will not report your individual responses, nor will we identify you as a participant in the survey. This survey is for research purposes only.

This study will take about 20 minutes to complete and we ask that you complete the survey in one sitting (without taking any breaks) to avoid distractions.

Form Approved: OMB No. 0910-XXXX

Expiration Date: XX/XX/XXXX

Public Disclosure Burden Statement

Public reporting burden for this collection of information is estimated to average 20 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to:

Department of Health and Human Services

Food and Drug Administration

CDER/PRA Comments/HFS-24

5100 Paint Branch Parkway

College Park, MD 20740-3835