WIC Participant

OMB Approval No. 0584-XXXX

Approval Expires: XX/XX/20XX

Appendix EE.1

Infant Weight and Length Measurement Appointment Script - ENGLISH

PHONE/EMAIL SCRIPT:

Thank you for your continued participation in the WIC Feeding My Baby Study. As you know, as part of the study, we need to get [CHILD]’s length and weight from time to time.

When we last spoke with you on [LAST INTERVIEW DATE] you said that you are no longer visiting the WIC clinic at [CURRENT SITE NAME] and [CHILD] does not have a regular health care provider who can give us [his/her] current weight and length.

We would like to make an appointment to come to your home to get [CHILD]’s current length and weight. The visit will take no more than 30 minutes. The measurements will be taken by a trained professional from [HOME HEALTH AGENCY NAME]. They will contact you soon to make an appointment at your convenience. They will bring all equipment needed for the measurement and only take length and weight. They will not conduct any medical examinations or offer any medical advice.

You will receive $20 for completing the visit.

Please let me know if you have any questions. You can contact me at [PHONE NUMBER] or [EMAIL ADDRESS].

Thanks.

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB number.  The valid OMB control number for this information collection is 0584-XXXX.  The time required to complete this information collection is estimated to average 1 minute 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.