"Pain Level Chart Template With Faces"

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Pain Level Chart
You can describe your pain to the healthcare provider using any of the choices given below:
Type of pain (Tick as applicable)
Throbbing
Stabbing
Dull
Aching
Pinching
Steady
Localized
Pervasive
Chronic (persistent)
Acute (in the moment)
Other comments / Notes: ____________________________________________
Use the chart below to estimate your pain level.
Other comments / Notes:
(Include details on time when you felt the pain as well as activities that triggered the pain.)
www.FreePrintableMedicalForms.com
Pain Level Chart
You can describe your pain to the healthcare provider using any of the choices given below:
Type of pain (Tick as applicable)
Throbbing
Stabbing
Dull
Aching
Pinching
Steady
Localized
Pervasive
Chronic (persistent)
Acute (in the moment)
Other comments / Notes: ____________________________________________
Use the chart below to estimate your pain level.
Other comments / Notes:
(Include details on time when you felt the pain as well as activities that triggered the pain.)
www.FreePrintableMedicalForms.com