Join our Spinal Champion® Community Here

We’re so excited you’re here! Use this form to tell us your story of healing and recovery so that you can give others hope.

Spinal Champion®

  • Patients facing a debilitating back or neck condition can often feel lost, alone, and overwhelmed – but the road to recovery doesn’t have to be a lonely one. Our Spinal Champions program brings together individuals who have achieved improved quality of life through treatment for their neck or back pain to share their own stories of hope and provide encouragement to other patients. Spinal Champions help others find strength, comfort, and peer-to-peer support in a community that understands. We would like to share your story to help give hope to others. In your own words, please answer the following questions:

  • Max. file size: 2 GB.
  • I, (First & Last Name)
  • hereby irrevocably authorize the National Spine Health Foundation, its agents and assigns the unrestricted right to produce and use in any format (including the use of any electronic or similar media) including without limitation my voice, my person, likeness and/or medical devices that are used by me internally or externally (all such media representations sometimes referred to as my "likeness"). On behalf of myself, my personal representative and assigns, I transfer, and release any and all claims of ownership of the media representations of my likeness so produced to the National Spine Health Foundation to be used by them and their assigns for their exclusive use without any further consideration, or my prior approval. All such representations of my likeness may appear in any publications of the National Spine Health Foundation (electronic or print), including without limitation, the National Spine Health Foundation website, brochures, advertisements, and/or publications. I understand that all or a portion of any such likenesses may involve the disclosure and use of individually identifiable health information or other medical records; accordingly, this release is to be applicable to all information governed by the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

    If you have any questions or concerns, please email efredericks@spinehealth.org

Hear from other Spinal Champions® on our Get Back To It Podcast, stories of hope and recovery and join our Facebook Support Group.

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