Pediatric Migraine Clinical Trial
Complete the survey to see if you qualify.
Is your child currently between the ages of 6 and 11 (inclusive)?
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Yes
No
Has your child had a history of migraines for 6 months or longer?
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Yes
No
I'm not sure
Does your child weigh more than 15 kg (33 lbs)?
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Yes
No
I'm not sure
If you would like Central States Research to contact you regarding this clinical trial, please provide a phone number:
*
By submitting this form, I confirm that I am 18 years of age or older and am the legal parent or guardian filling out this survey on behalf of the participant.
Format: (000) 000-0000.
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