The primary reason that the developers of questionnaires copyright them is for the well-being of patients. Like any mechanical or electrical instrument, a great deal of care and expertise has gone into making them precision instruments. Many studies have provided developers with the knowledge of how to word and select the right questions, formulate the responses, select time specifications, optimize the page formulation for accurate completion, conduct validation studies (measurement properties and whether the instrument is measuring what it is meant to measure), and provide users the wherewithal to place a clinical interpretation on the data. For the same reason that one would never think of changing the numbers on the dial of a mechanical spirometer, one should never change a precision questionnaire in any way without the developer's permission. Even very small changes can destroy validity. We have all heard horror stories caused by the use of rogue questionnaires. These include incorrect clinical decisions, loss of entire clinical trials, incorrect interpretation of clinical and research studies, and confusion about which is the authorized version.