CCT Online Screener

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:

LjR3RqoIrjmQNsxHGgCjMC2FeHv8QYH68yDosbiqxVmnjPjHV8aYmrrHdXArKMNPhRfQLCipXFzMv7ubDq3wrJFH5uhxLUmstq4MhGwbM9wxxtKXu27zq

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Thank you for your interest in our suicide prevention research study at the University of Pennsylvania.

Please complete the survey below. This information will only be used to evaluate your eligibility for the study and will not be stored if you do not enroll in our study.

Note: By proceeding with the survey, you are giving consent to complete the pre-screening questionnaire. This information will only be used to evaluate your eligibility for the study. All of your information will be kept confidential and only accessed by the study team for the purpose of evaluating your eligibility.
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