Pain Evaluation

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1 – 4$26.90
5 – 9$24.10
10 +$21.10
SKU: 3690P
Updated 2022

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

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