Pain Management

Your First Name
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Your Last Name
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Phone Number
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Your E-mail Address
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How would you rate your current physical health?
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What does your pain feel like?
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Where is your pain?
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How did it start?
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When did it start ? (Date)
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What makes the pain worse?
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What makes the pain better?
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What time of day is your pain worse?
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Does pain interrupt your sleep?
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Do you have psychosomatic symptoms?
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Are you currently taking any medication?
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If yes name the medication
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  • - How do you prefer to communicate with Dr. David? -
  • Live in Dubai or Lebanon
  • Via video sessions
- How do you prefer to communicate with Dr. David? -
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