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 North American 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:

YSvi8XFiBHEcHAHJGJhdcID5eNrPZFZxiXBZrM939KYwArqS7Q22AqTFJvCKrpwVqjJhmYW5G5iptD8KanZYNKnrBQSTy9teFJ4qTX3BJE4MosfwtcIWi9

NOGGIN Eligibility Survey

Returning?

A A A

Welcome to the NOGGIN study sign-up survey.

Thank you for being interested in this innovative research study about atrial fibrillation! Please answer the following questions to determine if you are a candidate for this study. If you qualify for this study, we will reach out to you with more details.

Your answers will not impact your medical care. All your information will be stored securely at Duke University and seen only by trained study staff.

You will be able to delete your information from our records at any time after submitting your survey by contacting us at noggin@duke.edu.

Contact information that will be collected: Email Address, First and Last Name, and how you would like to be contacted.

Page 1 of 4

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.