Current Problem Pain Diagram Template
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1Current Problem Pain Diagram
Mark the area of your body where you feel painful sensations. Use the appropriate symbol. Please draw your face
Numbness, pins and needles, burning
OOOOOOOOOO
Aching, grabbing, cramping
XXXXXXXXXXXXX
Shocking, stabbing, electric
\\\\\\\\\\\\\\\\\\
Rate your neck or back pain on a scale from 1-10:
(Best) 1
2
3
4
5
6
7
8
9
10 (Worst)
Rate your arm or leg pain on a scale from 1-10:
(Best) 1
2
3
4
5
6
7
8
9
10 (Worst)
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0 votes
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Parent category: Medical