Get the free Orofacial Pain Examination Form - G. Joel Funari

ADVANCED ORAL AND FACIAL SURGERY OF THE MAIN LINE, PC G. JOEL FUN ARI, M.S., D.M.D. Official Pain Examination Form Please complete pages 1 through 4. Circle choices whenever available. Name Date SSN

How to fill out orofacial pain examination form

How to fill out orofacial pain examination form

1. Start by gathering all necessary information about the patient, including their medical history, previous treatments, and any relevant test results.
2. Introduce the patient to the orofacial pain examination form and explain the purpose and importance of filling it out accurately.
3. Ensure that the form includes sections for recording patient demographics, chief complaints, and detailed descriptions of pain symptoms.
4. Provide clear instructions on how to rate the severity of pain, such as using a numerical scale or visual analog scale.
5. Include sections to document the patient's medical conditions, medication usage, and allergies.
6. Incorporate questions about the impact of pain on daily activities, such as eating, speaking, and sleeping.
7. Add sections to assess any associated symptoms, such as headaches, earaches, or jaw clicking.
8. Include questions related to potential triggers or aggravating factors, such as chewing, cold stimuli, or stress.
9. Provide blank spaces for the patient to write additional comments or information that may be relevant to their case.
10. Ensure that the form has clear instructions on where and how to return or submit the completed document.

Who needs orofacial pain examination form?

1. The orofacial pain examination form is necessary for anyone who experiences orofacial pain or discomfort.
2. This includes individuals with temporomandibular joint (TMJ) disorders, facial neuralgias, headaches, or any other conditions affecting the orofacial region.
3. Healthcare professionals, such as dentists, oral and maxillofacial surgeons, or orofacial pain specialists, may also require this form to better understand their patients' symptoms and develop appropriate treatment plans.

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