A free preventive cardiology service for patients and their asymptomatic family members was established at a large teaching hospital in the southeastern United States to provide medical triage and risk reduction counseling for prevention of coronary heart disease. Patients and families were informed about the service and invited to attend during a personal visit from members of the preventive cardiology consultation service. Our study was designed to explore determinants of decisions to attend the clinic. We conducted telephone interviews with 62 consecutive patients to collect data on individual perceptions of health risks, factors that modify perceptions of health risks and ability to make behavior changes, and actions taken to reduce risk of disease. Of the 62 patients interviewed, 39% had attended the clinic. Patients hospitalized for myocardial infarction or bypass surgery were more likely to attend the clinic than those who had angioplasty or catheterization without bypass surgery.