Pain Self Assessment
Does your pain interfere with your ability to walk, sit, stand, sleep or lift?


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Do you change positions frequently because you are uncomfortable?


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Is your pain affecting your personal relationships?


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Are daily over-the-counter (OTC) medications necessary to manage your pain?


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Does your pain interfere with your ability to complete routine chores at home?


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In order to process your free assessment, please complete the information below so one of our health care professionals may assist you. Your personal information is confidential and will not be shared or used for any purposes other than this assessment.
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