Response Card 1st Survey

Att 2b - Response Card 1st Survey.docx

[NCBDDD] The Study to Explore Early Development (SEED) Follow-up Study

Response Card 1st Survey

OMB: 0920-1392

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Thank you for your previous contributions to the Study to Explore Early Development (SEED)! We hope you will take part in a new series of SEED studies to learn how different types of children grow older.


You are under no obligation to take part in these studies. Your participation helps us learn more about how we can support children with autism and other developmental disabilities and their families.


Shape1

STEP 1: Check one of the boxes below.




Shape2

YES, please contact me. I would like to learn more about the SEED Follow Up Studies.


Shape3

NO, I am not interested in learning more about the SEED Follow Up Studies.


(Optional) Child’s Name and ID: __________________________________

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STEP 2: Complete the following information and return this card in the

postage-paid envelope.





Your Name _____________________________________ Your Contact Information

Child’s Name ___________________________________ Home Phone ________________________________

Address _______________________________________ Cell Phone __________________________________

_______________________________________________ Email ______________________________________

_______________________________________________



I prefer to be reached by (circle one): Telephone Text E-mail


Best time to reach me is (circle one):  Morning Afternoon Early Evening 


I prefer materials to be sent in (circle one):  English Spanish


If you prefer, you can contact us by phone at <number>, by text at <number>, or by emailing us at <email address>.   


If you text or email us, please give us your name and a telephone number or email address where we can reach you.  



February 2022


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorLaura Schieve
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File Created2023-07-29

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