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INSERT BARCODEAFFIX PATIENT LABELING AND SYMPTOM MANAGEMENT CLINIC REFERRAL FORM PAIN AND SYMPTOM MANAGEMENT CLINIC REFERRAL FORM SF0022Rev. 11/2017The NIGH Pain and Symptom Management Clinic consists

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How to fill out pain and symptom management

01

Identify the main symptoms and pain experienced by the individual

02

Consult with a healthcare provider to determine the best treatment plan

03

Fill out a pain and symptom management form with detailed information about the symptoms, pain levels, and any previous treatments

04

Follow the instructions provided by the healthcare provider for managing symptoms and pain

05

Keep track of any changes in symptoms or pain levels and update the pain and symptom management form accordingly

Who needs pain and symptom management?

01

Individuals experiencing chronic pain or symptoms that impact their daily life

02

Patients undergoing treatment for a serious illness or disease

03

Elderly individuals who may have difficulty managing pain and symptoms on their own

04

Anyone seeking to improve their quality of life by managing pain and symptoms effectively

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What is pain and symptom management?

Pain and symptom management involves the treatment of and relief from pain and other symptoms experienced by a patient.

Who is required to file pain and symptom management?

Healthcare providers, particularly those caring for patients with chronic or terminal illnesses, are required to file pain and symptom management reports.

How to fill out pain and symptom management?

Pain and symptom management reports are filled out by healthcare providers documenting the patient's symptoms, the treatments provided, and the outcomes.

What is the purpose of pain and symptom management?

The purpose of pain and symptom management is to improve the quality of life for patients by alleviating their pain and discomfort.

What information must be reported on pain and symptom management?

Information such as the patient's symptoms, the medications prescribed, any side effects, and the effectiveness of the treatments must be reported on pain and symptom management forms.

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