Share Your Success Story With Us....


Use the form below to tell us how our information and / or products helped you to get rid of your back and get your life back. The more specifics and details the better.

 


Contact Information
First Name *
Last Name *
Email *
Phone *
How did you learn about Healthy Back Institute? *
What condition have you suffered from? *
Condition - Other
How long had you been in pain? *
Rate your pain level before using our products *
Which products / treatments did you use? *
How long have you been using our products? *
Rate your pain level after using our products *
What activities can you do now that you were not able to do before due to your pain? *
Share your story with us: *
Please enter the Security Code shown below:
n/a