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Online Assessment

Please answer each of the following questions by clicking the YES or NO button. Upon completion of the online assessment, you will be directed to the PREMIUM Trial physician Locator to find a participating physician near you.

  1. Are you between the ages of 18 and 65?  

  2. Do you suffer or have you been diagnosed with migraine headaches?  

  3. Do you experience approximately 6 to 14 migraine headache days per month?  

  4. Have your migraine headaches been unresponsive to 2 or more different preventive headache medications?  

  5. Have you ever been diagnosed with a stroke or Transient Ischemic Attack (known as TIA)?  

  6. Have you been diagnosed with any of the following: Parkinson's disease, Amyotrophic lateral sclerosis (ALS), Dementia, Multiple Sclerosis or Brain tumor?  

  7. Do you have any serious health problems related to your kidneys,
    liver, pancreas, heart or lungs (such as kidney failure, liver failure, tumors, etc.)? 

  8. Have you been treated with Botox for any reason in the last four months?  

  9. Are you currently pregnant or have the desire to become pregnant within the next year?  

  10. Are you currently participating in any other clinical trials?