THANK YOU FOR YOUR INTEREST IN OUR RESEARCH

If you are interested in participating in our research, please complete the following screening form to determine your eligibility.

PERSONAL INFO

PLEASE INDICATE "YES" OR "NO" TO THE FOLLOWING QUESTIONS

Are you interested in participating in behavioral studies?	Yes No
Are you interested in participating in fMRI studies?	Yes No
Are you right handed?	Yes No
Are you a native English speaker?	Yes No
Have you had any major head trauma (e.g., a concussion) within the last two years?	Yes No
Have you had a stroke?	Yes No
Do you have a history of emotional or psychiatric problems (e.g., depression or anxiety disorder)?	Yes No
Are you currently taking any anti-depressant medications?	Yes No
Do you have a history of any learning disorder (e.g., attention deficit disorder, dyslexia)?	Yes No
Do you have a diagnosis of a neurological or movement disorder?	Yes No
Have you had any major surgeries (e.g., heart) within the last year?	Yes No
Do you have any history of alcohol or drug abuse?	Yes No
Do you have diabetes?	Yes No
Have you ever had cancer or radiation therapy?	Yes No
Do you have any history of heart disease?	Yes No
Do you have untreated high blood pressure?	Yes No
Do you have a history of seizures (consider even one a long time ago)?	Yes No
Do you have normal or corrected to normal vision?	Yes No
Are you colorblind?	Yes No
Do you wear a hearing aid?	Yes No
Have you had electroconvulsive therapy?	Yes No
Have you had open-heart surgery within the last 2 years?	Yes No
Do you have any history of vascular disease?	Yes No
Do you have electrodes implanted for pain control or for seizures?	Yes No

PLEASE LIST ANY MEDICATIONS YOU ARE TAKING AND WHY