In the past 30 days have you done any of the following activities? Select all that apply.
Throughout our lives, most of us have had pain from time to time (such as minor headaches, sprains and toothaches). Have you had pain other than these everyday kinds of pain during the last week?
On the diagram, tap once to mark a circle in the areas where you feel pain. Double tap to put an X on the area that hurts most.
*Limited to 15 locations
Please rate your pain by selecting the one number that best describes your pain at its worst in the last week.
No Pain Pain as bad as you can imagine
What treatments or medications are you receiving for your pain?