Date
Veteran’s Address Appendix V
In Reply Refer To: 636/151
RE:
Dear Veteran,
A representative from clinical research at the Omaha Veterans Medical Center may be calling you in the next few weeks to explain a current clinical study. This study concerns the use of a drug for the treatment of ______. This call is to provide information about the study, answer any questions, and schedule an appointment if you are interested in participating.
The VA representatives will identify themselves and ask for your permission to explain the study. If you answer “No,” the call will be ended. There will be no effect on your VA medical care or benefits if you choose to answer “No.”
If you give permission to continue the call, it will take about 10 minutes of your time. We will explain the study, ask some questions about your medical history, and answer your questions. If you are interested in the study and appear to meet the criteria, we will schedule an office visit.
Please be assured that all personal health information you provide during the phone call will be kept entirely confidential and used only to determine your eligibility for research studies. It will not be used for any other purpose.
This study has been approved by the Omaha VA Human Studies Committee (IRB) and the Research and Development Committee. If you have questions about the Research Service or want to verify that this study is legitimate, call the Administrative Officer for Research at 402 995-3541 or toll-free to 1-800-451-5796 ext. 93541. If you have questions about this specific study or the phone call you will receive please call the clinical study coordinator, ______(name and phone number of clinical study coordinator) or toll free 1-800-451-5796 ext. 9-______(extension of study coordinator). Another source of information about VA clinical research is http://www.clinicaltrials.gov/.
Sincerely,
Rev: July 2015