Pueblo Nerve Project
If nerve pain has diminished your quality of life, apply to the Pueblo Nerve Project below.  Our 12 week treatment plan is designed to restore healthy movement, decrease pain and restore quality of life. It’s free to apply. We will be in touch with you after you submit your application to let you know if you qualify and what the next steps are. 
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Email *
Name *
Phone Number *
What is your age range? *
Do you have any medical implants such as a pacemaker or a nerve blocker?  *
Do you have an active blood clot that you are being medically treated for, or under a Doctor’s supervision?  *
Do you experience pain, numbness, tingling, loss of strength and/or sensation in your hands and/or feet? Check all that apply. *
Required
Do your symptoms listed above interfere with your quality of life?  *
How many hours of sleep, on average, do you get a night? *
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Rate your quality of sleep with 0 being very poor and 10 being the best sleep ever. *
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Rate your overall energy levels with 0 being very poor and 10 being excellent: *
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List your top 5 activities/hobbies that bring you joy, even if you are unable to perform them at this time:  *
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