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

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

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Required format:

Lzvksr3GZJQWSnQ7Mt9z7BVu8acLhsb7SikoqeGYUDd4ueS8LHUZcfSzu8jtoy2U4yveCBMAjYzLw4uU4KJdFrQywRwpIuNjBk2PG

Please complete the survey below.

Thank you!

E-Cigarette & Pregnancy Study

Thank you for your interest in our research study about health behaviors in pregnant women. This study is being sponsored by the Presbyterian Health Foundation University Hospital Authority and Trust Team Science Grant. This screening survey will ask a few questions so we can see if you qualify for the study "Health behaviors during pregnancy" at the University of Oklahoma Health Sciences Center (IRB #: 10974).

This screener is voluntary, and you may choose not to answer any question; however, we may not be able to determine if you are eligible for the study if you do not answer all of the questions. All of your answers will be kept confidential and will not be shared without your permission or except as required by law.

By completing this screener you will be providing private health information which means there is a potential risk for loss of confidentiality. You will not be paid for taking this pre-screen survey. Your private health information will be kept separate from your personally identifiable information (name, contact information) and identified only with an ID number. Your personally identifiable information will be stored on a password protected server that can only be accessed by approved study personnel. If you have questions or want to complete the survey via phone, please call 405-271-7759 or email us at MyHealth@ouhsc.edu.

If you appear eligible based on these responses, we will contact you to tell you about the study and schedule an appointment. If you do not qualify for the study, your contact information will be retained for tracking purposes, but your personal identifying information will be kept separate from the responses you provided.

YOU MUST COMPLETE THE SURVEY FOR YOURSELF ONLY. TO AVOID BEING DISQUALIFIED, DO NOT COMPLETE THIS SURVEY FOR SOMEONE ELSE OR HAVE SOMEONE ELSE COMPLETE IT FOR YOU. ALSO, PLEASE COMPLETE THIS SURVEY ONLY ONCE.

Indicating your interest below will serve as your consent to be screened for this study.

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