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Get Dr. Dervish's Patient Pain Questionnaire - Baycare Clinic

Your pain? (Check one for each item) Decrease Increase No affect Lying down Standing Sitting Walking Exercise (if applicable) Medication Relaxation Thinking about something else Coughing/Sneezing Alcoholic drinks Anything else that makes your pain better? worse? 21. Please check all of the treatments you have tried for your pain and complete columns on right: Treatment Dates Results Exercise Physical th.

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