Pain Assessment Tool - Appling Healthcare - ahcs 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your name, date, and time at the top of the form. This information is essential for tracking your pain assessment.
3. In section 1, indicate where your pain is located on the provided diagram. Use arrows if your pain radiates from one area to another.
4. Next, check the word that best describes your pain from the list provided. This helps in understanding the nature of your discomfort.
5. For section 3, write down when your pain started. This historical context can be crucial for healthcare providers.
6. In section 4, circle whether your pain is occasional or continuous to give a clearer picture of its persistence.
7. Indicate what time of day your pain is worst in section 5 by selecting from morning, afternoon, evening, or nighttime options.
8. Choose a face that best represents how you feel in section 6; this visual aid can help convey emotional aspects of pain.
9. Rate your pain on a scale from 0 to 10 in section 7. This quantifies your experience and assists in treatment evaluation.
10. Complete sections about what alleviates or worsens your pain and any treatments you are receiving. These insights are vital for effective management.

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