Register Your Organization
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Organization information
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Contact information
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Agreement
Thank you for your interest in the PainCAS: Clinical Assessment System.
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Organization Name
Address 1
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City
State
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Alabama
Alaska
American Samoa
Arizona
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Delaware
District of Columbia
Federated States of Micronesia
Florida
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Hawaii
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Marshall Islands
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Tennessee
Texas
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Vermont
Virgin Islands
Virginia
Washington
West Virginia
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ZIP Code/Postal Code
Organization Size
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0-10
11-25
26-50
Over 50
What EHR do you use?
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Epic
Allscripts Professional
Allscipts Touchworks
Cerner
e-Clinical Works
athenahealth
Practice Fusion
NextGen Healthcare
GE
Greenway
Other
Type of Use?
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Research Study
Publication Inclusion
In Practice
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