Skip survey header

INvisible Project: Health care disparities

U.S. Pain Foundation is looking for patients to feature in its upcoming INvisible Project magazine focused on health care disparities. Please fill out this form if you are interested in being featured. If you are selected, someone from U.S. Pain will contact you in 2-3 weeks.
1. Please provide your contact information. *This question is required.
2. Do you live with chronic pain? *This question is required.
3. Do you live with any of these specific conditions? Please check all that apply. *This question is required.
  • Neurological
  • Endocrinological
  • Musculoskeletal
  • Gastrointestinal
  • Gynecological
  • Autoimmune/Rheumatological
  • Hematological
  • Oncological
  • Infectious Disease
4. What is your race/ethnicity?
5. Are you Hispanic or Latino(a)? *This question is required.
6. Are you LGBTQ+? *This question is required.