BACKGROUND AND OBJECTIVES: This study's purpose was to determine how conditions of payment influence attendance at preventive health examinations. METHODS: A multi-practice study of 65 general practitioners (GPs) was conducted in two areas in the county of Aarhus, Denmark. The GPs invited 2,452 men aged 40-49 to a preventive health examination for coronary heart disease (CHD). The examination was free in one area but cost $40 in the other area. A risk profile was estimated, based on a summation of points for risk factors for CHD, including blood pressure, serum cholesterol, smoking behavior, body mass index, and family history of CHD. RESULTS: Attendance at the examinations was 37% in the required payment area and 66% in the free area. Of the total attenders, 13% had an increased risk of CHD. A slight but significant tendency, a lower risk for developing CHD, existed among attenders who paid for the examination. CONCLUSION: A requirement for payment for health examination leads to fewer patients obtaining examinations.