Do You Have A Slipped Disc That Causes Leg Pain? Study Researches New Investigational Medication

Consent to Continue

After completing this brief questionnaire for the Slipped Disc & Leg Pain study, more detailed information will be given to you before you decide whether or not to take part in the research, and you will have the opportunity to speak with and ask questions of a study coordinator.

All information you provide in this questionnaire will be held in strict confidence, and shared only with the research centre conducting the study. This information may be shared without your permission if required by law.
You can stop this interview at anytime and request that your information be deleted from our records.

Are you willing to continue? *This question is required.