What is your gender?
What is your race?
If you chose 'Other' for racial background how would you describe it?
Are you of Hispanic, Latino or Spanish origin?
What is the highest level of education you have completed?
What is your relationship status?
How many times have you been divorced?
Years:
Months:
How many romantic relationships have you had?
How many children do you have?
In the past month, have you taken medication for psychiatric reasons (including stimulants and mood stabilizers)?
If you menstruate, when was the the date of your last period (please answer in the form [mm/dd/yyyy])? Put 'not menstruating', if you do not menstruate.
If you menstruate, what is the length in days of your typical cycle? Put 0, if you do not menstruate.
Are you taking any form of hormonal birth control?
If you chose 'Yes' for using hormonal birth control, which type are you using? (List brand and type if known):
What is your household's annual income (in US dollars)?
Do you have a retirement account?
If you do have a retirement account what percent is in stocks?
What is your housing status?
How much mortgage debt do you have?
How much car-related debt do you have?
How much education debt do you have?
How much credit card debt do you have?
Please list any other sources of debt you have:
If you listed any other sources of debt, how much debt do you have from these other sources?
On average, how many cups of coffee do you have each day?
On average, how many cups of tea do you have each day?
On average, how many cans of caffeinated soda do you have each day?
What is your daily caffeine intake from other sources each day (in mg)?
Do you feel you have a problem with gambling?
How many traffic tickets have you gotten in the last year?
How many traffic accidents have you been in over your life?
How many times in your life have you been arrested and/or charged with illegal activities?
What are your motivations for participating in this experiment?
If you have other motivations, please list them.