Please allow for enough time to complete the course in one session. You will have to start over if you exit without completing all activities to the finish page.

required *

What is your gender? *

What is your marital status? *

What is your employment status? *

How satisfied are you with your medical care for pain? *

Have you been deployed to either Afghanistan or Iraq? *

Do you have a personal history of alcohol or other drug abuse? *

Are you currently being prescribed opioids/narcotics (oxycodone, methadone, vicodin, Percocet, etc.)? *

How do you rate your quality of life? *