redcap.chop.edu
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159.14.198.10
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Submitted URL: http://redcap.chop.edu/surveys
Effective URL: https://redcap.chop.edu/surveys/
Submission: On January 03 via manual from US — Scanned from DE
Effective URL: https://redcap.chop.edu/surveys/
Submission: On January 03 via manual from US — Scanned from DE
Form analysis
1 forms found in the DOMPOST /surveys/
<form id="survey_code_form" style="font-weight:bold;margin:0 0 10px;font-size:16px;" action="/surveys/" enctype="multipart/form-data" target="_self" method="post">
<div>
<span data-rc-lang="survey_619">Please enter your access code to begin the survey.</span><input name="code" maxlength="20" class="x-form-text x-form-field" style="margin:0 4px 0 10px;font-size:16px;width:120px;padding:4px 6px;" type="text"
autocomplete="new-password">
<button class="jqbutton ui-button ui-corner-all ui-widget" onclick="
var ob = $('input[name="code"]');
ob.val( trim(ob.val()) );
if (ob.val() == '') {
simpleDialog(window.lang.survey_634);
return false;
}
$('#survey_code_form').submit();
"><span data-rc-lang="survey_200">Submit</span></button>
</div>
<div style="font-size:14px;font-weight:normal;color:#777;margin-top:30px;margin-bottom:50px;"><span data-rc-lang="survey_642">Please note that the access code is *not* case sensitive.</span></div>
</form>
Text Content
Working... 0% means 50% means 100% means This value you provided is not a number. Please try again. This value you provided is not an integer. Please try again. The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again. The value you provided must be within the suggested range The value you provided is outside the suggested range This value is admissible, but you may wish to double check it. The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19). This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now. This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now. This field must be a valid email address (like joe@user.com). Please re-enter it now. The value you provided could not be validated because it does not follow the expected format. Please try again. Required format: /^((0?[1-9])|([1-8][0-9])|(9[0-8]))[0-9]{3}$/ /^((29([-\/])02\3(\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1\d|2[0-8])([-\/])(0[1-9]|1[012]))|((29|30)([-\/])(0[13-9]|1[012]))|(31([-\/])(0[13578]|1[02])))(\11|\15|\18)\d{4}))$/ /^((02([-\/])29\3(\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1[012])([-\/])(0[1-9]|1\d|2[0-8]))|((0[13-9]|1[012])([-\/])(29|30))|((0[13578]|1[02])([-\/])31))(\11|\15|\19)\d{4}))$/ /^(((\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00))([-\/])02(\6)29)|(\d{4}([-\/])((0[1-9]|1[012])(\9)(0[1-9]|1\d|2[0-8])|((0[13-9]|1[012])(\9)(29|30))|((0[13578]|1[02])(\9)31))))$/ /^((29([-\/])02\3(\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1\d|2[0-8])([-\/])(0[1-9]|1[012]))|((29|30)([-\/])(0[13-9]|1[012]))|(31([-\/])(0[13578]|1[02])))(\11|\15|\18)\d{4})) (\d|[0-1]\d|[2][0-3]):[0-5]\d$/ /^((02([-\/])29\3(\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1[012])([-\/])(0[1-9]|1\d|2[0-8]))|((0[13-9]|1[012])([-\/])(29|30))|((0[13578]|1[02])([-\/])31))(\11|\15|\19)\d{4})) (\d|[0-1]\d|[2][0-3]):[0-5]\d$/ /^(((\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00))([-\/])02(\6)29)|(\d{4}([-\/])((0[1-9]|1[012])(\9)(0[1-9]|1\d|2[0-8])|((0[13-9]|1[012])(\9)(29|30))|((0[13578]|1[02])(\9)31)))) (\d|[0-1]\d|[2][0-3]):[0-5]\d$/ /^((29([-\/])02\3(\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1\d|2[0-8])([-\/])(0[1-9]|1[012]))|((29|30)([-\/])(0[13-9]|1[012]))|(31([-\/])(0[13578]|1[02])))(\11|\15|\18)\d{4})) (\d|[0-1]\d|[2][0-3])(:[0-5]\d){2}$/ /^((02([-\/])29\3(\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1[012])([-\/])(0[1-9]|1\d|2[0-8]))|((0[13-9]|1[012])([-\/])(29|30))|((0[13578]|1[02])([-\/])31))(\11|\15|\19)\d{4})) (\d|[0-1]\d|[2][0-3])(:[0-5]\d){2}$/ /^(((\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00))([-\/])02(\6)29)|(\d{4}([-\/])((0[1-9]|1[012])(\9)(0[1-9]|1\d|2[0-8])|((0[13-9]|1[012])(\9)(29|30))|((0[13578]|1[02])(\9)31)))) (\d|[0-1]\d|[2][0-3])(:[0-5]\d){2}$/ /^(?!\.)((?!.*\.{2})[a-zA-Z0-9\u0080-\u02AF\u0300-\u07FF\u0900-\u18AF\u1900-\u1A1F\u1B00-\u1B7F\u1D00-\u1FFF\u20D0-\u214F\u2C00-\u2DDF\u2F00-\u2FDF\u2FF0-\u2FFF\u3040-\u319F\u31C0-\uA4CF\uA700-\uA71F\uA800-\uA82F\uA840-\uA87F\uAC00-\uD7AF\uF900-\uFAFF!#$%&'*+\-/=?^_`{|}~\d]+)(\.[a-zA-Z0-9\u0080-\u02AF\u0300-\u07FF\u0900-\u18AF\u1900-\u1A1F\u1B00-\u1B7F\u1D00-\u1FFF\u20D0-\u214F\u2C00-\u2DDF\u2F00-\u2FDF\u2FF0-\u2FFF\u3040-\u319F\u31C0-\uA4CF\uA700-\uA71F\uA800-\uA82F\uA840-\uA87F\uAC00-\uD7AF\uF900-\uFAFF!#$%&'*+\-/=?^_`{|}~\d]+)*@(?!\.)([a-zA-Z0-9\u0080-\u02AF\u0300-\u07FF\u0900-\u18AF\u1900-\u1A1F\u1B00-\u1B7F\u1D00-\u1FFF\u20D0-\u214F\u2C00-\u2DDF\u2F00-\u2FDF\u2FF0-\u2FFF\u3040-\u319F\u31C0-\uA4CF\uA700-\uA71F\uA800-\uA82F\uA840-\uA87F\uAC00-\uD7AF\uF900-\uFAFF\-\.\d]+)((\.([a-zA-Z\u0080-\u02AF\u0300-\u07FF\u0900-\u18AF\u1900-\u1A1F\u1B00-\u1B7F\u1D00-\u1FFF\u20D0-\u214F\u2C00-\u2DDF\u2F00-\u2FDF\u2FF0-\u2FFF\u3040-\u319F\u31C0-\uA4CF\uA700-\uA71F\uA800-\uA82F\uA840-\uA87F\uAC00-\uD7AF\uF900-\uFAFF]){2,63})+)$/i /^[-+]?\b\d+\b$/ /^[a-z]+$/i /^\d{10}$/ /^\d{8}$/ /^[a-z0-9-_]+$/i /^[-+]?[0-9]*\.?[0-9]+([eE][-+]?[0-9]+)?$/ /^-?\d+,\d$/ /^-?\d+\.\d$/ /^-?\d+,\d{2}$/ /^-?\d+\.\d{2}$/ /^-?\d+,\d{3}$/ /^-?\d+\.\d{3}$/ /^-?\d+,\d{4}$/ /^-?\d+\.\d{4}$/ /^[-+]?[0-9]*,?[0-9]+([eE][-+]?[0-9]+)?$/ /^(\(0[2-8]\)|0[2-8])\s*\d{4}\s*\d{4}$/ /^(?:\(?([2-9]0[1-9]|[2-9]1[02-9]|[2-9][2-9][0-9]|800|811)\)?)\s*(?:[.-]\s*)?([0-9]{3})\s*(?:[.-]\s*)?([0-9]{4})(?:\s*(?:#|x\.?|ext\.?|extension)\s*(\d+))?$/ /^((((\+44|0044)\s?\d{4}|\(?0\d{4}\)?)\s?\d{3}\s?\d{3})|(((\+44|0044)\s?\d{3}|\(?0\d{3}\)?)\s?\d{3}\s?\d{4})|(((\+44|0044)\s?\d{2}|\(?0\d{2}\)?)\s?\d{4}\s?\d{4}))(\s?\#(\d{4}|\d{3}))?$/ /^\d{4}$/ /^[ABCEGHJKLMNPRSTVXY]{1}\d{1}[A-Z]{1}\s*\d{1}[A-Z]{1}\d{1}$/i /^(0[1-9]|[1-9]\d)\d{3}$/ /^\d{3}-\d\d-\d{4}$/ /^.{0,150}$/ /^.{0,200}$/ /^(\d|[01]\d|(2[0-3]))(:[0-5]\d){2}$/ /^([0-9]|[0-1][0-9]|[2][0-3]):([0-5][0-9])$/ /^[0-5]\d:[0-5]\d$/ /^[0-9]{4,9}$/ /^\d{5}(-\d{4})?$/ xJLtaTWdERTHaxEdEYfQErtvc2x5mXuA6DJSfFE3VfYVbR6RIdvg4SCKJzvZ9bC4vN9MQmXInWosVa4yDS9tucY Please enter your access code to begin the survey. Submit Please note that the access code is *not* case sensitive. Powered by REDCap