The code block below illustrates how one might use # and // as comments in your logic and calculations.

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The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

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This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

About you and your back pain

Please complete the surveys below. They should take you 5-10 minutes. Your responses will help your chiropractor monitor your progress over time. Additionally, your chiropractor is participating in a quality improvement program called MIBAC - the Michigan Back Collaborative. As a participant, your doctor is dedicated to improving the outcomes for patients with back pain throughout the state, and your responses will aid in this mission!

Your responses are not shared with anyone outside of the MIBAC Coordinating Center and your chiropractor. Any data utilized for the program is de-identified, removing any information that could potentially identify you.

Thank you!

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.