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Request to Survey IPSIS Membership- Request Submission Form
Members who wish to conduct a survey of the International Pain and Spine Intervention Society's membership may submit their request to the Research Division for consideration.


Restrictions:

In order to be considered, this application must be submitted by an IPSIS non-trainee member.

Study affiliation with any industry entity is not permitted.

Solicitations for survey participation with reimbursement are not permitted.

Each investigator must complete the Society's online disclosure.  

 

Your Information (Required)

First Name:
Last Name:
E-mail Address:
Phone Number:

 

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