Chronic Low Back Pain

Aspen Clinical Research is currently taking part in a medical research study for adults 18 through 75 who suffer from Chronic Low Back Pain. In this study, researchers are evaluating the investigational pain medication to gain more information on how well it reduces Chronic Low Back Pain.

In order to participate in this study, each person will go through a screening process, which is a series of study-related tests and evaluations to determine if he or she can participate.

Space in the study is limited. Health insurance is not required. All study-related visits, tests, and study drug will be provided to participants at no cost. In addition, reimbursement for study-related time and travel may be provided.

Please complete the form below to see if you pre-qualify for the study.

For more in-depth information regarding this study please click HERE.

Disclaimer: Not all individuals that complete the on-line questionnaire will qualify for the study. An in-depth study and medical evaluation must be completed in person in order to qualify for the study.

Study Questionnaire

First Name (required)

Last Name (required)

Email Address

Male or Female?
Address/Street Name

City

State

Zip

Date of Birth (MM-DD-YYYY)(required)

Primary Phone (required)

Other Phone

Best Time to Call:
Have you participated in a clinical research study at Aspen before?
Referral Source
Referral Name
Have you had moderate to severe chronic low back pain for 3 months or longer? (required)
Have you been taking an opioid pain medication regularly for 14 days or more for your chronic low back pain? (required)
Does your current pain medication relieve your chronic low back pain adequately? (required)
Please list the name, dose, and frequency of any medications you are currently taking:

Are you interested in learning more about other studies?

Before an individual can participate in a clinical research
study, Aspen Clinical Research is required to receive study participants medical
records from their primary care physician. Would you like to expedite this
process by taking 2-3 minutes to fill out the HIPAA (Privacy Act) form after clicking
the "Send" button below? (required)

Type the following in the input box