Research participation portal

Welcome to the QPRN research projects mailing list! By providing the information required in the following registration questionnaire, you consent to do it voluntarily, without any obligation and no consequence in case of refusal on your part. Depending on the information provided, in particular with regard to your pain, the scientific team of the QPRN will analyze them and send you free of charge by email, if applicable, the research project name of the QPRN members who might interest you as well as the name and contact details of persons to contact to participate. You will be free to contact the persons at any time and please note that we do not take any action on your behalf with them. The only people who will have access to the information provided in the registration questionnaire will be members of the scientific team of the QPRN. Thanks for your interest!

Step 1 of 3 – YOUR INFORMATIONS

First Name
Last Name
Year of birth
Email*
Phone number (optional)
Language understood and spoken
What biological sex were you assigned at birth?
How do you identify yourself in terms of gender?
What region do you live in?
In the case of projects that require one or more visits to a researcher's laboratory, can you come to:

YOUR MAIN PAIN
What is the location of your main pain?
What is the cause of this pain?
To choose more than one answer, click in the drop-down menu as many times as necessary.
Since when do you suffer from it?
Please select the number that best describes your pain during the past 7 days, on a scale from 0 (no pain) to 10 (worst pain I can imagine).
What are you currently using for the treatment of your pain?
To choose more than one answer, click in the drop-down menu as many times as necessary.
YOUR SECONDARY PAIN
What is the location of your secondary pain?
What is the cause of this pain?
To choose more than one answer, click in the drop-down menu as many times as necessary.
Since when do you suffer from it?
Please select the number that best describes your pain during the past 7 days, on a scale from 0 (no pain) to 10 (worst pain I can imagine).
What are you currently using for the treatment of your pain?
To choose more than one answer, click in the drop-down menu as many times as necessary.
OTHER PAIN
Do you have other pain?
To choose more than one answer, click in the drop-down menu as many times as necessary.

Head
Face
Neck
Shoulder(s)
Arm(s)
Elbow(s)
Wrist(s)
Hand(s)
Upper back
Lower back
Chest
Abdomen/stomach
Hip(s)
Buttock(s)
Anal region
Genital region
Leg(s)
Knee(s)
Ankle(s)
Feet

Research participation portal

Step 1 of 3 – YOUR INFORMATIONS

YOUR MAIN PAIN

YOUR SECONDARY PAIN

OTHER PAIN

Finalization of your registration