Pain assessment form pdf 2026

1. Click ‘Get Form’ to open the pain assessment form in the editor.
2. Begin by entering the date, patient’s name, age, and room number at the top of the form. This information is crucial for identifying the patient and their specific needs.
3. In the LOCATION section, either you or the nurse can mark on the provided drawing to indicate where the pain is felt.
4. For INTENSITY, have the patient rate their pain using a scale. Fill in present pain, worst pain experienced, best pain level, and an acceptable level of pain.
5. Indicate whether the pain is constant by checking YES or NO. If it’s not constant, specify how often it occurs.
6. Describe the QUALITY of pain using terms like ache or sharp in the designated field.
7. Document ONSET, DURATION, VARIATIONS, and RHYTHMS of the pain in detail to provide a comprehensive overview.
8. In MANNER OF EXPRESSING PAIN, note how the patient expresses their discomfort.
9. List what RELIEVES PAIN and what CAUSES OR INCREASES IT in their respective sections.
10. Assess EFFECTS OF PAIN on various aspects of life such as sleep and relationships. Provide detailed comments as needed.
11. Finally, add any OTHER COMMENTS and outline a PLAN for management at the end of the form.

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