Health History and Behavior

Hello and welcome!
This research is being conducted by Lisa Gaynier and Steve Slane, members of the Psychology Department at Cleveland State University.

This study is part of a program of research investigating the ways in which people report health information to their physicians. In order to include as broad and diverse a sample as possible, we are using a “snowball” technique of sampling. This involves sending the survey to friends who forward to their friends, and so on. We welcome your assistance in sharing our survey with your community.

The survey procedure involves:
1. Viewing a video introduction of the study presented by a doctor.
2. You will respond to a health history questionnaire like the one you receive at your doctor's office.

The survey will take approximately 15 minutes. Your responses will be confidential. We do not collect identifying information such as your name, email address or IP address, therefore, there will be no way for the researchers to link your responses with your identity.

All data is stored in a password protected electronic format. To help protect your confidentiality, the surveys will not contain information that will identify you. The results of this study will be used for scholarly purposes only.

This research is approved by Cleveland State University’s Institutional Review Board (216.687.3630). By participating in this research, you are supporting the development of our knowledge about health information. If you have questions, please contact Lisa at or 216.523.7266 or Steve at Thanks for your help on this important research.

ELECTRONIC CONSENT: Please select your choice below.
Clicking on the "agree" button below indicates that:

• you have read the above information
• you voluntarily agree to participate
• you are at least 18 years of age