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Ocean

Pain Impact

Survey Instructions

Please answer all questions by checking the box to the left of your answer. 

1. In the past 7 days, how often did you have pain so bad that you could not do anything for a whole day?
2. In the past 7 days, how often did you have pain so bad that you could not get out of bed?
3. In the past 7 days, how often did you have very severe pain?
4. In the past 7days, how often did you have pain so bad that you had to stop what you were doing?
5. In the past 7 days, how often did you have pain so bad that it was hard to finish what you were doing?
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