Pain Evaluation
Updated 2022
Download a sample today!
Briggs Pain Evaluation form compliments your compliance with F697.
It includes the Wong-Baker FACES® Pain Rating Scale as well as the PAINAD Scale (used when the individual is unable to communicate the level of pain or be interviewed) to collect and evaluate an individual's pain level, intensity, frequency, location, etc.
It provides prompts for recording:
•The pain management program
•The effect pain has on the individual's function
•Relief of pain
•Non-pharmaceutical interventions
•Effectiveness of medication/interventions
•Plan of care
•Progress notes, etc.
Download a sample today!
Size: 8 1/2" x 11"
Paper: White 20# bond
Ink: Black, prints 2-sides
Punching: 5-holes top and side
Packaging: 100 per pad
Paper: White 20# bond
Ink: Black, prints 2-sides
Punching: 5-holes top and side
Packaging: 100 per pad