Register Below To Hear The Experts Laxmaiah Manchikanti, MD Mahendra R. Sanapati, MD Bill W. Haney, MD REGISTER NOW Pain Talk March Broadcast Registration Please enable JavaScript in your browser to complete this form.Name *FirstLastAddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmail *PhoneSelect your preference of timesThursday, March 25, 5:30pm CTSunday, March 28, 3:00pm CTWhere did you hear about the Pain Talk Virtual SeminarOnlineNewspaperWeb siteCurrent or Past PatientOtherDo you currently suffer from any pain conditions?YesNoWould you like to receive the Pain Management Centers of America email newsletter?YesNoNot nowAre there any questions you have?You may submit up to 5 questions and the Pain Experts will try to answer as many questions as possible during the seminar.Submit PADUCAH CENTER:67 Lakeview Drive, Paducah, KY 42001P: 270.554.8373 | F: 270.554.8987E: [email protected]| W: pmcoa.us EVANSVILLE CENTER:1101 Professional Boulevard, Evansville, IN 47714P: 812.477.7246 | F: 812.477.7240E: [email protected] | W: pmcoa.us