SENSUSTM Pain Management Doctor Discussion Guide

What symptoms do you experience? Check all that apply.
How would you describe the severity of your pain when it is at its worst? 0 = No pain; 10 = Most pain
When is the pain worst for you?
Does your pain prevent you from:
How often does the pain interfere with your sleep?
My symptoms prevent me from (check all that apply):
sleeping
exercising
working
walking
shopping
shores
Do your symptoms make you depressed or anxious?
What parts of your life are affected by your pain?
Do you currently take medication for your pain?
If yes, what are you taking?