Scribd Logo
Upload

Welcome to Scribd!

  • Printable Pain Diary

    Uploaded by

    Anestil
    33 views1 page
    This daily pain diary tracks a patient's pain levels, types of pain experienced, sites of pain, medications and treatments taken, and their effectiveness in providing relief. Key information recorded includes intensity of pain on a 0 to 10 scale, types of pain described as aching, burning, pins and needles or stabbing, times of pain throughout the day, prescription medications and supplements taken and their impact on pain relief. Alternative treatments and appointments for chemotherapy, immunotherapy or radiation are also noted.

    Original Description:

    Original Title

    printable-pain-diary

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    This daily pain diary tracks a patient's pain levels, types of pain experienced, sites of pain, medications and treatments taken, and their effectiveness in providing relief. Key information recorded includes intensity of pain on a 0 to 10 scale, types of pain described as aching, burning, pins and needles or stabbing, times of pain throughout the day, prescription medications and supplements taken and their impact on pain relief. Alternative treatments and appointments for chemotherapy, immunotherapy or radiation are also noted.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    33 views1 page

    Printable Pain Diary

    Uploaded by

    Anestil
    This daily pain diary tracks a patient's pain levels, types of pain experienced, sites of pain, medications and treatments taken, and their effectiveness in providing relief. Key information recorded includes intensity of pain on a 0 to 10 scale, types of pain described as aching, burning, pins and needles or stabbing, times of pain throughout the day, prescription medications and supplements taken and their impact on pain relief. Alternative treatments and appointments for chemotherapy, immunotherapy or radiation are also noted.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    Date: Daily Pain Diary

    Intensity of Pain:

    0 1 2 3 4 5 6 7 8 9 10
    No Pain Moderate Pain Extreme Pain

    Type of Pain:

    Aching Burning Pins and Shooting Squeezing Stabbing


    Needles

    Time of Pain: Site of Pain: Activity at Time of Pain:

    AM PM All day

    Prescription Medications Taken:

    Dosage:
    Relief: None Some Complete Supplements Taken:

    Appointments:
    Chemotherapy Immunotherapy Radiation

    Over-the-Counter Medications Taken: Other Notes:

    Dosage:
    Relief: None Some Complete

    Alternative Treatments:

    Relief: None Some Complete

    You might also like