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1206D1065WHERE IS THE PAIN? Draw the location of your pain by shading on the diagram to the right: Primary Care Provider: ___ ___REFERRAL: Doctor that sent you to clinic with address: ___ ___ ___CHIEF
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How to fill out referred pain common areas

01
Identify the area where the pain is actually felt, known as the referred pain area.
02
Locate the source of the pain, which may be in a different area of the body.
03
Understand the anatomical connections between the referred pain area and the source of the pain.
04
Consult with a healthcare provider for a proper evaluation and treatment plan.

Who needs referred pain common areas?

01
Individuals experiencing pain that is felt in a different location than the actual source of the pain.
02
Healthcare professionals and students studying pain referral patterns.
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Referred pain common areas are areas of the body where pain is felt, but the source of the pain is actually in a different location.
Healthcare professionals and doctors are required to report referred pain common areas in their patients.
To fill out referred pain common areas, healthcare professionals need to accurately document the location of the pain and its source.
The purpose of referred pain common areas is to accurately diagnose and treat the underlying cause of the pain.
The information that must be reported includes the location of the pain, the source of the pain, and any relevant medical history.
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