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a~ <br />Appendix 3: Telephone Survey Script <br />MILL CREEI{ SURVEY INTRODUCTORY SCRIPT <br />"Hello, my name is and I am calling from the Orange County Health Department. <br />May I speak to the head of the household or adult of the home? A group of citizens from your <br />community reported concerns to the Orange County Commissioners about the number of cancer <br />diagnoses in your neighborhood,. We are conducting a survey to gather additional information about <br />cancer cases in the Mill Creek Road area." <br />"May we have a few moments of your time to ask you some questions about your medical history? <br />Answering the survey questions is completely voluntary, and your participation will be greatly <br />appreciated." <br />A) Special Instructions: If person says no, thank them for their time and hang up politely. <br />Document across top of survey - "Declined". <br />Special Instructions: If person prefers to be surveyed at a later time, log their preferred time and <br />date.. <br />CZSpecial Instructions: If person says, yes, thank them for their willingness to participate and <br />explain that the survey will take about 20 minutes to complete and that all information will be kept <br />confidential. <br />Dl Special Instructions: If person answering the call does not live at this address (i.e. landlord), <br />request the name and phone number of the person who does live there, Thank them for their time <br />and hang up politely. <br />At Completion of Survey: "Thaiil< you for participating in this interview. The Health Department <br />will be providing summary information to the community when the analysis is complete. We <br />appreciate your time." <br />Page 27 of 47 <br />