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:

V9RtKDz7ihyuLp2pWrL3a5RS2UJm7xNTEiTRqukQjw6yF2Sp4vuaSjQh

Project S.A.S.S.Y. Interest Form

Thank you for your interest in the Seattle Area Smoking and Screening studY (SASSY). The goal of this study is to work with members of the LGBTQ+ community (YOU!) to build programs for smoking cessation and lung cancer screening.

Not local to Seattle, WA? Remote options available.

Please complete the survey below. The study coordinator will be in contact with you shortly.

Questions? Call Madison Snidarich @ 206-667-4589.

Thank you!

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.