Pediatric Migraine Study

Does a child in your care suffer from Migraines?

Would you child like to try an investigational medication for children adolescents with Migraines at no cost to you?

Volunteers who take part in the study may be compensated for time and travel.

Sign up and we will notify you of clinical trials in your area that need children and adolescents ages 6-17 with Migraines.

No health insurance is required to participate. Participants will receive all study-related visits, tests, and care from a dedicated medical team at no cost. The study will involve up to three visits to a study site in your area.

What happens if I sign up?

The child may be eligible for a Pediatric Migraine clinical research study, also known as a clinical trial in your area. Someone from the study team or study site conducting the trial will contact you to explain more about this research study before you make your decision about participating.

Sign Up

Fields marked with an * are required.

If you are under the age of 13 (or 16 if you are in California or in Europe), you may not directly enter any information and your legal parent or guardian must enter this information on your behalf. By filling out this form, you are confirming that you meet these requirements.

Who are you interested in this study for? *

First Name of Potential Participant *

Last Name of Potential Participant *

Date of Birth MM/DD/YYYY of Potential Participant *

Zip Code or Postal Code of Potential Participant *

Is the Potential Participant Male or Female?

Does the Potential Participant suffer from migraine headaches? *

Has the Potential Participant been experiencing migraine headaches for at least 6 months? *

How long have you – or the Potential Participant (if filling this out for them) – been experiencing migraine attacks? *

How many migraine attacks does the Potential Participant experience per month (on average)? *

If left untreated, do the Potential Participant’s migraine headaches typically last at least 3 hours? *

Has the Potential Participant ever taken any medication to treat a migraine? *
These may include Acetaminophen (Tylenol), Ibuprofen (Advil, Advil Migraine, Motrin), Naproxen (Aleve), Aspirin or medications prescribed by your doctor for migraine.

Have you – or the Potential Participant (if filling this out for them) – been diagnosed (by a doctor) with any other medical conditions? *
(For example: Cancer, HIV, Hepatitis B, Hepatitis C, epilepsy, seizures, stroke, liver disease, Raynaud’s disease, diabetes, cardiovascular disease, psychosis, schizophrenia).
Please list here or write 'none'
Please only include conditions which have been diagnosed by a doctor.

Is the Potential Participant currently taking any medications for their health conditions? *
Please list them here or write 'none'.

Is the Potential Participant between 44 and 297 lbs? *

If the Potential Participant is female, is she currently pregnant or breastfeeding? *

First Name of caregiver/parent to contact *

Last Name of caregiver/parent to contact *

Phone Number of caregiver/parent to contact *

Email of caregiver/parent to contact

What is the best day/time to reach you via telephone (we know you are busy)? *
Please note that most of our Trial site/research centers are open Monday to Friday 8am – 5pm. If possible, please provide availability in this time window. Our Trial sites will do their best to accommodate your request, however they may not be able to reach out outside of their business hours.

Do you consent to the collection and processing of your personal data (including information about your health, race and ethnicity (as applicable); including disclosure to our Research Partners) for the purpose of recruitment into clinical research studies? *

Yes

The information you are providing here will be processed in accordance with our Privacy Policy, which describes our data privacy practices, including how we share your information with our Research Partners and use your information to send you details about potential clinical trial opportunities. When you submit this information, you consent to AutoCruitment’s use of your data as described in our Privacy Policy. By providing your phone number and clicking “Submit” below, you consent to receive messages, including SMS/MMS text messages, sent by or on behalf of AutoCruitment, with information about research studies for which you may be eligible. By clicking Submit, you also agree to our SMS Terms. If you have any questions regarding the handling of the information you have provided to AutoCruitment, or if you would like to make any changes or withdraw your consent, please contact us at info@autocruitment.com.