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Search for:
Home
What is Upper Cervical?
About Us
Meet the Staff
Services and Techniques
Wellness Partners
What to Expect
Online Forms
Health Resources
Success Stories
Concussions
Contact Us
Quadruple Visual Analogue Scale
Quadruple Visual Analogue Scale
admin
2017-07-30T13:44:07+00:00
Quadruple Visual Analogue Scale
Name
Date
Circle the number that best describes the question being asked for each individual complaint.
What is your pain right now?
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8
9
10
What is your typical or average pain?
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3
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9
10
What is your pain at its best?
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1
2
3
4
5
6
7
8
9
10
What percentage of your awake hours is your pain at its best?
What is your pain at its worst?
0
1
2
3
4
5
6
7
8
9
10
What percentage of your awake hours is your pain at its worst?
Place an X on the areas with pain or discomfort.
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