This paper reports on a specific Web-based self-report data collection system that was developed for a public health research study in the United States. Our focus is on technical outcome results and lessons learned that may be useful to other projects requiring such a solution. The system was accessible from any device that had a browser that can support HTML5. Report findings include: which hardware devices, Web browsers, and operating systems were used, the rate of survey completion, and key considerations for employing Web-based surveys in a clinical trial setting.