Patient Pain Assessors

Use these tools to work with patients in your practice who are experiencing chronic pain. Together you can determine how their pain is impacting their mood, daily life, physical function, and overall well-being.

Roll over each title to read a full description of each form.

Documents that are customizable are indicated by a  

Pain Assessment ToolsCustomizable

Pain Diary

CustomizableDownload PDF

Pain Checklist

CustomizableDownload PDF

Pain History

CustomizableDownload PDF

FACES Pain Rating

Download PDF

Psychosocial Assessment Documents

CAGE Alcohol Screening Instrument

Download PDF

Drug Use Questionnaire

Download PDF

Functioning Assessment

Function and Goal Setting

CustomizableDownload PDF

Pain Disability Index

CustomizableDownload PDF

Quality of Life Scale

Download PDF

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