Please read the following consent form carefully, then follow the link to
the EAT-26 self analysis.
Eating Attitudes Test Consent Form:
FOR QUESTIONS ABOUT THE STUDY, CONTACT: Alejandro Martinez or Vivian Crisman, Cowell Student
Health Service, 870 Campus Drive, Stanford, CA 94305-8580, (650) 724-2273
DESCRIPTION: In recognition of Eating Disorder Awareness Week, we will be providing an
eating attitudes questionnaire (the EAT-26) through this website for students to use. Our
main intent is to provide resource information to students who may have questions or issues
related to their eating habits and/or food relationship. Our secondary goal is to use the
anonymous EAT-26 data to track the incidence of self-reported eating disorders/disordered
eating on the Stanford campus. You are invited to participate in this research study.
Our primary intent in this process is to provide Stanford students with a short-term website
containing campus and non-campus resources for addressing eating issues. We will be collecting
anonymous responses to a standardized questionnaire, the EAT-26, as a means of tracking the
frequency and severity of disordered eating patterns on campus, through self-reported data.
We hope to provide some insight into the health status of Stanford students in this area, as
little data is currently available on our student population, to help in future health education
By completing the EAT-26 questionnaire, you are participating in a research study.
Only the raw data from filling out the questionnaire will be collected. In no way will we be
able to assess who has filled out the questionnaire. As well, you will not be asked to provide
us with any personal information which may be used to identify you.
RISKS AND BENEFITS: A subject who is very concerned about a potential eating disorder may find
it stressful to receive a recommendation to follow-up with a health/mental health professional.
If you choose to fill out this survey, you may stop at any time. As well, if you begin to feel
distressed by the questions or the results you receive, please consult our resource page for the
Cowell Student Health Service resources available to you.
By filling out this survey, you can reasonably expect to:
- increase your awareness of available resources related to health and nutrition issues, both on
and off campus.
- receive a recommendation to follow-up with a Cowell Student Health Service professional if you
score high on the EAT-26 questionnaire.
- learn how to help a friend who may have an eating disorder/disordered eating.
Stanford students in general may reasonably be expected to benefit from this study as well,
because the data gathered will be used to develop more effective and directed programming on
campus to address health and nutrition issues.
TIME INVOLVEMENT: If you agree to allow us to use your anonymous data, the EAT-26 questionnaire
takes approximately 5-8 minutes to complete.
PAYMENTS: There is no payment associated with filling out the survey or submitting your raw scores.
AGE: By clicking the consent button below, you acknowledge that you are at least 18 years of age.
SUBJECT'S RIGHTS: If you have read this form and have decided to participate in this research study,
please understand your participation is voluntary and you have the right to withdraw your consent
or discontinue participation at any time without penalty. You have the right to refuse to answer
particular questions. Your individual privacy will be maintained in all published and written
data resulting from the study. No personal identifying information will be required to complete
If you have questions about your rights as a study participant, or are dissatisfied at any time
with any aspect of this study, you may contact - anonymously, if you wish - the Administrative
Panels Office, Stanford University, Stanford, CA (USA) 94305-5401 (or by phone (650) 723-2480 -
you may call collect).
Please print this page if you would like to keep a copy of this consent form.
Click below if you certify that you are at least 18 years of age and consent to the above.
I certify that I am at least 18 years of age
and have read and agree to the terms above.
If you choose not to fill out the survey, please follow this link to our resource page.