1 of 3

How often is your body in pain?

Cartoon Face: Smile

Not often

Cartoon Face: Neutral

Sometimes

Cartoon Face: Frown

Very often

2 of 3

What part of your body hurts the most?

Cartoon Body: Knee Pain

Knees

Cartoon Body: Hip Pain

Hips

Cartoon Body: Elbow Pain

Elbows

Cartoon Body: Back Pain

Back

Cartoon Body: Other Pain

Other

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What best describes your level of pain?

Cartoon Pain Scale: Green

Mild discomfort Cartoon Pain Scale: Yellow

Cartoon Pain Scale: Yellow

Moderate discomfort Cartoon Pain Scale: Red

Cartoon Pain Scale: Red

Severe discomfort

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