Research Study Application

Thank you for your interest in the Clinical Research Trials conducted at the Michigan Head Pain & Neurological Institute.

Clinical research trials conducted at MHNI will include individuals who fulfill specific enrollment criteria for each study and generally live within 100 miles of Ann Arbor, MI so they can can easily travel to the institute for evaluation and treatment.

Please complete the following profile and a Clinical Research Associate will contact you within 48 hours. Alternatively, you may contact the Research Department directly by calling (734) 677-6000 option 4 (available Monday-Friday, 8am and 5pm).
Research Study Application Contact Information
Research Areas of Interest
How Did You Hear About Research at MHNI?
Questions/Comments For Study Nurse:

The message area below should not be used by individuals who have a clinical circumstance under question which needs direct involvement of a medical professional. Individuals who need direct involvement of a medical professional should contact him/her directly.

Providing this information is voluntary and will be kept as private as possible. Your information will not be sold or shared with other parties. By submitting this form we have your permission to securely and indefinitely keep your information on file or database and to contact you for possible participation in a future research study. Your information will be removed from the database at any time, just by contacting us.