The CBO will only contact the patient if there is no indication in the ServiceRequest that such contact is prohibited.  The closing the loop with the patient is primarily intended for the entity creating the referral (Payer, Provider, CP) and not the CBO.  The patient is commenting on the CBOs ability to provide a satisfactory service in response to specific questionnaire.  It is up to the patient to answer the questions or to refuse to respond.  If the response is to the CP or the CBO, then any communication to the Provider is out of scope for this IG. Will include this clarification in the IG.