Health Awareness, Inc. is a clinical research company that co-exists with Family Practice Associates and Dr. Surowitz. Clinical Trial participants receive all study related care at no cost as well as compensation for time and travel. Your information will not be shared with anyone outside of our office. Please take a moment to fill out the form below. You may also contact us directly at 561-741-2033 to get more information about our current and upcoming studies.

First Name:

Last Name:

Email:

Phone:
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D.O.B.:


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List any current prescriptions or medications:


Please indicate all studies that you would consider participating in:
  • Acne
  • ADHD
  • Allergy
  • Alzheimers
  • Antibiotics
  • Anxiety
  • Arthritis
  • Asthma
  • Back Pain
  • Cholesterol
  • Constipation
  • Contraception
  • COPD
  • Depression
  • Diabetes
  • Diabetic Neuropathy
  • Erectile Dysfunction
  • Fatigue
  • Feet Problems
  • Fibromyalgia
  • Gastroenterology
  • GERD
  • Gout
  • Hand Pain
  • Headaches
  • Healthy Volunteers
  • Heartburn
  • Hip Pain
  • Hormone
  • Hot Flash
  • HPV
  • Hyperlipidemia
  • Hypertension (Including ABPM)
  • Insomnia
  • Irritable Bowel(IBS)
  • Low Sex Drive
  • Mania
  • Men’s Health
  • Migraine
  • Neck Pain
  • Osteoarthritis
  • Osteopenia
  • Osteoporosis
  • PAP
  • Perennial Allergic Rhinitis
  • Questionnaires
  • Rhinitis
  • Seasonal Allergic Rhinitis
  • Strep Throat
  • Sinusitis
  • Seasonal Allergies
  • Skin Conditions
  • Stomach Discomfort
  • Smoking
  • Thyroid
  • Upper Respiratory Infections
  • Vaccines
  • Women’s Health
  • Weight Loss
  • YR Round Allergies

Additional Information: