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Click ‘Get Form’ to open the bpi short form in the editor.
Begin by entering your Study ID# and Hospital # at the top of the form. Ensure these details are accurate for proper identification.
Fill in the date and your name, including your last name, first name, and middle initial.
Indicate whether you have experienced pain today by selecting 'Yes' or 'No'.
On the provided diagram, shade in areas where you feel pain and mark an 'X' on the area that hurts the most.
Rate your pain at its worst, least, average, and right now by circling the appropriate number from 0 to 10.
List any treatments or medications you are currently receiving for your pain.
Circle the percentage that reflects how much relief you have received from treatments in the last 24 hours.
For each category (General Activity, Mood, etc.), circle a number from 0 to 10 indicating how much pain has interfered with those aspects of your life.
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The Bank Policy Institute (BPI) is an American public policy, research, and advocacy organization, based in Washington, D.C.
What is the BPI scale for pain?
Bureau of Public Inquiries.
What is the BPI short for?
The Brief Pain Inventory - Short Form (BPI-sf) is a 9 item self-administered questionnaire used to evaluate the severity of a patients pain and the impact of this pain on the patients daily functioning.
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