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 pain and get your life back. The more specifics and details the better.

Important Message: Please do not ask for help or request customer support from this form, as the results of this page are only viewed monthly, for customer service help, simply go back in your to the contact us page, and click on "Email Customer Service" and your request will be resolved.

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: *
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