The code block below illustrates how one might use # and // as comments in your logic and calculations.

This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

j8a5GciZMypeVTXkuL4nQYS

SNAP 2 Online Screening Survey

Congratulations on your pregnancy

Do you want help to stop smoking?

If so, you may want to join the Smoking, Nicotine and Pregnancy 2 (SNAP 2) Trial which will test new ways of supporting women who want to quit.

Please complete our 5-minute screening questionnaire to see if this study is suitable for you.

Your answers will be confidential and seen only by a small group of study researchers led from the University of Nottingham.

Many thanks for your help.

Dr Tim Coleman

Division of Primary Care, University of Nottingham

Mark field as:

[Clear value]

Missing (999)

Unknown (888)

Not applicable (777)

Not Done (666)

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.

SNAP 2 Online Screening Survey

SCREENING FORM 1

Where did you hear about the study?

You have selected an option that triggers this survey to end right now.