Traditionally health advice has been anchored in face-to-face settings but increasingly patients are using the Internet for their health advice needs. This means that patients are now offered inconsistent advice from a range of sources and must determine which sites to trust and which to reject. To understand how consumers make these choices, 13 participants diagnosed with hypertension took part in a longitudinal study in which they searched for information and advice relevant to their condition. A content analysis of the group discussions revealed support for a staged model of trust in which mistrust or rejection of Websites is based on design factors and trust or selection of Websites is based on content factors such as source credibility and personalization. Based on this model, a set of guidelines for developing trust in health Websites is proposed and key differences between face-to-face communication and web-based systems are discussed.