Treatment for the Relief of Chronic Low Back Pain

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If chronic low back pain interferes with your quality of life, you may be a candidate for the Intracept Procedure. To see if you might qualify for the INTRACEPT Procedure, please take a moment to complete the below and a patient representative will be in touch with you.

Name

Email Address

Please provide your phone number:

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What is your age?

Have you been struggling with chronic low back pain for at least 6 months?

Have you had a MRI in the past 12 months?

Over the past 6-month period, have you tried steroid injections or epidural injections?

Does the pain in your low back travel down to your legs or feet?

I consent to my submitted data being collected and stored. I consent to an appointment representative contacting me.*