[date]

RESIDENT
[Skimble's address]
Chicago, IL 606XX

Dear Resident:

To better serve all segments of the American population, the United States Public Health Service, part of the Department of Health and Human Services (DHHS), is conducting a national study on health-related issues (OMB Approval No. 0930-0110). Along with more than 200,000 other residences, your household was randomly selected. RTI [explained below] is under contract with DHHS to conduct the study, and soon one of their professional interviewers will be in your neighborhood to provide you with more information.

When the RTI representative arrives, please ask to see his or her personal identification card. (An example of the ID card is shown below.) he or she will ask you a few preliminary questions and then may ask one or possibly two members of your household to participate in a voluntary interview. It is also possible no one from your household will be asked to participate. If any members of your household are selected for the interview and choose to participate, they will receive a cash payment of $30 at the end of the interview.

Feel free to ask the RTI representative any questions you may have in the study. This research is authorized by Section 505 of the Public Health service Act. The confidentiality of the information collected is protected under Section 501 of the Public Health Service Act. The information collected is confidential and will only be used for research and analysis and cannot be used for any other purpose. This addressed is addressed to "Resident" because the initial selection is made by address, and we are unaware of your name.

Your help is extremely important to the success of this study, and we thank you in advance for your cooperation.

Sincerely yours,

Joseph Gustin
Assistant Project Officer, DHHS

David Cunningham
National Field Director, RTI
(800) 848-4079

[illegible signature]
Assigned Field Representative

[sample of RTI photo ID card]

• Have you ever smoked part or all of a cigarette?
  
• What is your best estimate of the number of days you drank alcohol during the past 30 days?
  
• Have you ever, even once, used marijuana or hashish?
  
• How much do people risk harming themselves physically and in other ways when they use cocaine once a month?
  
• How many times during the past 12 months have you and your spouse spent an hour or more together doing an activity that you both enjoyed?*
  
• During the past 12 months, was there any time when you needed mental health treatment or counseling for yourself but didn't get it?
  
• How many hours did you work last week at all jobs or businesses?
  
• In 2002, did you have money in any kind of savings or other bank account that earned interest?

What Happens to My Information?

Each computerized interview data file — which is identified only by a code number — is electronically to RTI on the same day the interview is conducted. The answers are then combined with all other participants' answers, and are coded, totaled, and turned into statistics for analysis. As a quality-control measure, you may receive a telephone call [!] or a letter from RTI to verify that the interviewer did complete the survey with you.