How would you rate your pain right now?
< Level 1
Level 10 >
How would you rate your pain in the last 24 hours?
1
10
How would you rate your pain at its least in the past 24 hours?
1
10
What number from 1-10 describes how, during the day, pain has interfered with your enjoyment of life?
1
10
What number from 1-10 describes how, during the past week, has pain interfered with regular activity?
1
10
What makes the pain better?
Are you experiencing any of the following benefits and/or side effects?
