Welcome to our survey

The purpose of this survey is to determine which studies you may be eligible for within the Department of Psychiatry and Behavioral Neuroscience and the High-Performance Electrical Neuroimaging (HPEN) Laboratory at the University of Chicago. Please fill it out as honestly and accurately as possible. All information disclosed here will remain completely confidential. This survey will take approximately 5 to 10 minutes to complete. Please note that some questions may be considered sensitive by some people. You do not have to answer any questions that make you feel uncomfortable.

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* 1. Please select your gender

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* 2. Are you older than 18?

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* 3. Please indicate your sexual orientation

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* 4. Have you ever had a head injury, skull fracture, or a diagnosed concussion?

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* 5. Are you in menopause?

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* 6. When was the last time you had your menstrual periods?

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* 7. Do you think you are (or could be) pregnant right now?

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* 8. Are you a nursing mother?

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* 9. Do you take a contraceptive pill?

 
20% of survey complete.

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