Request to join our online community

A Gift of Pain, Inc. is a private online community for those affected by congenital insensitivity to pain. You're more than welcome to join, but our stories are very personal. In order to maintain and protect the personal nature of our sanctuary of forums, we must approve all members before we can allow them access to the forums. Please fill out the form below to be considered for approval.

First Name: Last Name:

Street Address: City: State/Province:

Zip/Postal Code: Country:

Home Phone: Cell Phone:


Relation to person with insensitivity to pain:

Name of person with insensitivity to pain:

Your Story (why you want to join):

Share a gift of pain.

You may not realize just how important it is.