This is a legal form that was released by the Nevada Department of Health and Human Services - a government authority operating within Nevada. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is the purpose of Form FPO0802A?
A: The purpose of Form FPO0802A is to collect follow-up population contact information and consent in Nevada.
Q: Who needs to complete Form FPO0802A?
A: Anyone who participated in the Nevada Youth Tobacco Survey (NYTS) and is being contacted for follow-up needs to complete Form FPO0802A.
Q: What information is collected in Form FPO0802A?
A: Form FPO0802A collects contact information such as name, address, phone number, and email address. It also collects consent for future contact and access to health records.
Q: Do I have to give consent to complete Form FPO0802A?
A: No, giving consent is optional. However, providing consent allows for future follow-up and access to health records.
Q: What will my contact information be used for?
A: Your contact information will be used for future follow-up surveys and potential access to health records for research purposes.
Q: Is my information shared with third parties?
A: No, your information will not be shared with third parties. It will only be used for research and follow-up purposes.
Q: Can I opt out of future follow-up surveys?
A: Yes, you can opt out of future follow-up surveys by indicating your preference on Form FPO0802A.
Q: Can I revoke my consent after completing Form FPO0802A?
A: Yes, you can revoke your consent at any time by contacting the organization conducting the survey.
Q: Is completing Form FPO0802A mandatory?
A: No, completing Form FPO0802A is voluntary. However, providing accurate information helps with research and follow-up efforts.
Form Details:
Download a printable version of Form FPO0802A by clicking the link below or browse more documents and templates provided by the Nevada Department of Health and Human Services.