We are Inviting ALL Chronic Pain Patients, Patient Advocates, Medical & Legal Professionals, Group Members, Team Leaders & Site Owners from ALL PAIN GROUPS & ADVOCACY WEBSITES to Join Together & Fight for our Collective Cause.

If you're ready to UNITE & work TOGETHER as a COLLABORATIVE TEAM EFFORT, please complete this brief Questionnaire & we will contact you shortly.

We're running out of TIME and must do everything possible to change the RESTRICTIVE measures being taken against doctors and pain patients across the country.

We are still in the process of forming Teams to focus on specific tasks based on your experience & expertise. Please be patient, we all have physical limitations & understand there are days when our pain is too intense & prevents us from functioning. Please be assured that this is a JUDGEMENT FREE ZONE!

*NOTE* Please complete this Form ONLY if you're interested in volunteering your time. Otherwise, you can sign up to receive our Newsletter to stay up to date on the most current alerts, news, & calls to action by clicking here:

We look forward to working together to effectuate meaningful change. Thank you!

*Privacy Notice* YOUR PERSONAL INFORMATION WILL BE KEPT PRIVATE. However, we may share your First Name, Email & State with a few trusted Leaders for the purpose of organizing Teams. We will NEVER share/sell your information with a 3rd party.
Email address *
Please Provide Your FIRST & LAST NAME: *
Please Provide Your CITY, COUNTY & STATE: *
Please Provide Your PHONE NUMBER: (We will never share info without your permission) *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy