English Questionnaire Neck Pain

107x Filetype PDF File size 0.23 MB Source: www.dr-paul-louis.be

File: English Questionnaire Neck Pain

Neck Pain Questionnaire Dr. Louis- Antwerpen Page 1 of 5 Date: Patient data Last name: . First name: .. Date of birth: .... GSM number: ... E-mail: General practitioner: .. Referred by: Neck pain, tick ...

Filetype PDF | Posted on 02 Mar 2023 | 2 years ago

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...Neck pain questionnaire dr louis antwerpen page of date patient data last name first birth gsm number e mail general practitioner referred by tick the box and mark on drawing localisation localised in posterior all over mainly left right upper part just below skull describe pressure nagging stabbing burning is provoked movements keeping your head a certain position for longer period time bent forwards backwards turned to coughing straining defecate radiating there any front no yes towards sharp well defined indicate which area figure with dermatomes further temple forehead top eyes dull that difficult define numbness at level please specify tingling region can radiate temples combing hair painful skin hypersensitive limbs dermatome diagram delineate cold feeling extremities or worsened are sensory disturbances same as if not does occur state scheme arm influenced shoulder so provoke do you have reduced strength arms hands difficulty grasping things dropping grip fingers less wrists lif...

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Category: Uncategorized / Uncategorized
Posted on: 02 Mar 2023 | 2 years ago
Tag: download pdf, english, questionnaire, neck, pain,
Filetype: PDF
File size: 0.23 MB
Views: 107x
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