Do you suffer from Low Back Pain? | Palm Beach Research Center

Do you suffer from Low Back Pain?

Did you know almost 10% of the US population suffers from moderate to severe pain?

You may be eligible to participate in a research study if you:

Are 18 years of age or older
Suffer from moderate to severe low back pain
Currently taking a narcotic for your low back pain

Please complete the entire form below, and a Research Nurse will contact you

First Name:
Last Name:
Date of birth:
Sex:
Address:
City:
State:
ZIP:
Cell Phone:
Home Phone:
Email:

For additional information on this study, please contact Palm Beach Research Center at 689-0606