Physiotherapy Pain Assessment Template
Body-region pain picker, severity scale, duration timeline, prior-injury history.
Free while in beta · No credit card required
About this physiotherapy pain assessment template
For physiotherapy and pain clinics. The body-region picker (neck, shoulder, lower back, knee, etc.) lets the visitor self-localize without medical terminology. Severity (1–10) and duration questions help the practitioner triage acute vs. chronic cases before the session.
Conversion tips
Body-region picker outperforms text — patients click where it hurts. Severity scale + duration lets your therapist triage acute vs. chronic before the appointment, cutting session time by ~10 minutes.
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Free while in beta · Server-side tracking included · Cancel any time