Control Number
Tester ID
Appointment Contact Form sequence:
Tester Type
Was appointment scheduled?
Date  that contact was attempted (mm/dd/yyyy)
Date (mm/dd/yyyy) of scheduled appointment
Day of the week
Day of the week that contact was attempted
Who initiated contact?
If appointment was NOT scheduled, why not?
Site
if appointment was NOT scheduled and you selected other, please specify:
This form is complete
Time that contact was attempted (hh:mmAM/PM)
Time (hh:mm)
Type of contact
After you conveyed your sexual orientation to the agent, were you told that ther
If after you conveyed your sexual orientation to the agent, you were told that t
If you were not able to reach someone who was able to provide information, why n
If you indicated other as the reason why you were not able to reach someone who
Were you able to reach someone who was able to provide information?
When you conveyed your sexual orientation to the agent, please indicate what lan