Your school email address is required to register for the study. Your personal information will remain confidential.

Your School Email:

Are you interested in participating?

Yes No

What school do you attend?

Boston University Carlow University Carnegie Mellon University Chatham University Duquesne University George Mason University Goshen College Johns Hopkins University La Roche University Lehigh University Misericordia University Mt. Aloysius University Penn State University Abington Penn State University Altoona Penn State University Behrend Penn State University Brandywine Penn State University Greater Allegheny Penn State University Hazleton Penn State University Schuylkill Penn State University University Park PennWest California PennWest Clarion PennWest Edinboro Point Park University Portland State University Rowan University Slippery Rock University University of Bridgeport University of Florida University of Missouri-Columbia University of North Dakota University of Pennsylvania University of Pittsburgh University of Pittsburgh Bradford University of Pittsburgh Greensburg University of Pittsburgh Johnstown University of Pittsburgh Titusville University of Virginia Wayne State University West Liberty University West Virginia University

Please select your age:

Younger than 18 18 to 24 older than 24

Do you have a scheduled appointment with your school's clinic, health or counseling center?

Yes No

Appointment Date:

Appointment Time:

Submit Captcha validation is required.

Great! You are eligible to participate. Please fill out the following information so that we can send you pre-appointment survey and ensure you are paid promptly afterwards.

School Attend:

Boston University Carlow University Carnegie Mellon University Chatham University Duquesne University George Mason University Goshen College Johns Hopkins University La Roche University Lehigh University Misericordia University Mt. Aloysius University Penn State University Abington Penn State University Altoona Penn State University Behrend Penn State University Brandywine Penn State University Greater Allegheny Penn State University Hazleton Penn State University Schuylkill Penn State University University Park PennWest California PennWest Clarion PennWest Edinboro Point Park University Portland State University Rowan University Slippery Rock University University of Bridgeport University of Florida University of Missouri-Columbia University of North Dakota University of Pennsylvania University of Pittsburgh University of Pittsburgh Bradford University of Pittsburgh Greensburg University of Pittsburgh Johnstown University of Pittsburgh Titusville University of Virginia Wayne State University West Liberty University West Virginia University

First Name:

Last Name:

Middle Name:

Date Birth:

Preferred Email:

Alternative Email:

Preferred Phone:

Alternative Phone:

Preferred Contact Type:

By Email By Phone

Do we have permission to call you?

Yes No

Do we have permission to leave you a voice mail?

Yes No

Do we have permission to text you?

Yes No

Mailing Address

Street Line 1

Street Line 2

City Name

State Code

Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

5 Digits Postal Code

Submit

Consent Form

I have read and understood the information above:

Yes No

I agree to participate in this research study:

Yes No

Consent Name:

Consent Date:

Submit

Hi :

Thank you for agreeing to participate in the study asking about how health, sex, and alcohol play a role in your well-being as an undergraduate college student. Your feedback will support our research and goal of improving college student health.

Click here to take your pre-appointment survey.
You can expect this survey to take between 15-20 minutes. Please complete this survey BEFORE your appointment on .

After you meet with your provider, you will receive a very brief (5 minute) post-appointment survey link with a few additional questions.

Once both pre- and post-appointment surveys are completed, you will receive a $20 Amazon e-gift card.

Click here if you have to re-schedule your appointment.

Click here if you need to update your contact information.

In the event that you did not receive your survey or have payment questions, please reach out to this study's .

Save and Return Instructions:
• If you cannot complete the survey all at once, there is a save and return later option
• To utilize this function, scroll to the bottom of survey and click the button that says "Save & Return Later"
• Once you click the button, please follow the instructions for the validation code and the survey link for returning. If you forget your validation code or cannot access the survey link, please reach out to the study's .

We appreciate your time, but unfortunately you are not currently eligible for the study. If something changes or you'd like to reconsider, please return to the link where you began to rescreen for enrollment. Otherwise, thank you for inquiring!

Have a nice day!

We are not currently enrolling additional students at your school but appreciate your interest!

Thank you!