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FRONT

Pain Description: Numbness, Pins and Needles etc

Pain Location, ie: Top, lower, mid

Pain Scale: 1-10 (1 means discomfort and 10 being extreme pain)

BACK

Pain Description: Numbness, Pins and Needles etc

Pain Location, ie: Top, lower, mid

Pain Scale: 1-10 (1 means discomfort and 10 being extreme pain)

RIGHT

Pain Description: Numbness, Pins and Needles etc

Pain Location, ie: Top, lower, mid

Pain Scale: 1-10 (1 means discomfort and 10 being extreme pain)

LEFT

Pain Description: Numbness, Pins and Needles etc

Pain Location, ie: Top, lower, mid

Pain Scale: 1-10 (1 means discomfort and 10 being extreme pain)

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