Doctor visit pain summary: your pain on one page

Appointments are short, and the important things often come to mind only afterwards. Answer the twelve questions calmly at home. The result is a clear, factual one-page summary you can print or take along as a PDF.

Your answers stay in your browser. Nothing is sent anywhere. So you can come back later, a draft is kept only on this device (localStorage). “Delete draft” removes it.

Do not wait for your appointment if you have

  • a sudden, extremely severe headache
  • new weakness or paralysis, numbness, problems speaking or seeing, or confusion
  • fever with a stiff neck or with severe back pain
  • numbness around your genitals or bottom, or new problems controlling your bladder or bowels
  • chest pain, especially with shortness of breath, sweating or pain spreading to your arm or jaw
  • severe pain after an accident or a fall

Get medical help immediately: call your emergency number (999 in the UK, 911 in the US, 112 in the EU) or go to the emergency department.

0 of 12 steps filled in

1Why are you seeing the doctor?

Choose what fits. One sentence in your own words helps the practice understand.

2Where does it hurt?

Tap one or more areas. Tap again to deselect.

headface / jawneckchestabdomenpelvis / groinright hipleft hipright front of thighleft front of thighright shinleft shinright shoulderleft shoulderright upper armleft upper armright elbowleft elbowright forearmleft forearmright hand / wristleft hand / wristright kneeleft kneeright foot / ankleleft foot / ankle
Front
Seen from the front – your right side is on the left of the picture.
back of the headneckupper backlower backleft buttockright buttockleft back of thighright back of thighleft calfright calfleft shoulderright shoulderleft upper armright upper armleft elbowright elbowleft forearmright forearmleft hand / wristright hand / wristleft kneeright kneeleft foot / ankleright foot / ankle
Back
Seen from behind – your left side is on the left of the picture.

No area selected yet

Choose areas from a list

3Since when?

4How often and how is it changing?

Recently

5How bad is it?

0 means no pain, 10 the worst pain you can imagine. If you're unsure about a slider, just leave it untouched.

Not sure? See the pain scale with descriptions

6What does it feel like?

Pick every word that fits. The short explanations help you choose.

7What makes it better or worse?

Better with
Worse with

8How does it affect your daily life?

9What have you tried so far?

Medicines and how well they worked, including ones you bought yourself. Name and dose as on the pack.

Other treatments

10Any other symptoms?

Include things you do not connect with the pain.

11What do you want to ask?

Tap suggestions or write your own questions. Most important first.

12What do you want from the appointment?

A clear goal helps you use the time well.

Your summary

My pain – summary for my doctor's appointment

Date:

As soon as you fill something in, your summary appears here.

Filled in by the patient with the doctor visit summary from schmerztrack.app. Not a medical assessment.

The draft is saved only in this browser.

The summary organises what you enter. It does not diagnose and does not replace medical advice. With warning signs or in an emergency, call your emergency number.

Why a written summary makes the appointment easier

A GP appointment often lasts only a few minutes. In that time you are expected to explain where it hurts, since when, how badly and what you have already tried – and still ask your questions. Many people only realise on the way home what they forgot to say.

A prepared summary takes the pressure off. You do not have to search for words, your doctor gets the key facts in a fixed order, and there is time left for what matters to you. Health services such as the NHS and the U.S. National Institute on Aging recommend exactly this: write down your symptoms, medicines and questions beforehand and start with the most important one.

How to use the summary at your appointment

Fill in the questionnaire a day or two before, when you have time. You do not have to answer every question; empty fields do not appear on the summary. Print the result or save it as a PDF on your phone.

Hand the page over at the start of the consultation or read out the points. Add one sentence about what you want from today. During the appointment, note on the back what was discussed and what happens next. If something is unclear, ask – that is your right.

If you take several medicines, bring the packs or a medication list too. For headaches, the headache days counter helps as well; for pain that lasts longer, a pain diary.

What is on the summary – and why

The order follows what doctors usually ask: reason, location, onset and course, intensity on a scale of 0 to 10, the character of the pain, what changes it, what it means for daily life, previous treatments and how well they worked, and other symptoms. From these details doctors can tell types of pain apart, for example whether pain is more likely to come from nerves, joints or muscles.

Other symptoms matter even if they seem unrelated. Fever, weight loss, numbness or weakness change how urgently something needs to be looked into. The question about your goal helps steer the conversation: is it about finding a cause, better relief, a plan, or work and daily life?

If you feel you are not being taken seriously

Pain cannot be seen from the outside. Specific details help: not “it always hurts” but “on five days out of seven at level 6, I cannot sit for longer than ten minutes”. Describe what you can no longer do, not just how bad it is. And if an appointment does not help, you can ask for a referral or a second opinion.

Frequently asked questions

How do I prepare for a doctor's appointment about pain?

Write down where and since when it hurts, how bad it is (0–10), what it feels like, what makes it better or worse, which medicines you took and how well they worked, and what you want to ask. The summary on this page asks exactly that in twelve steps.

Are my answers stored or sent anywhere?

Nothing is sent. So you can continue later, your browser keeps a draft on this device. “Delete draft” removes it completely.

How do I save the summary as a PDF?

Tap “Print or save as PDF” and choose “Save as PDF” in the print dialog, or on an iPhone “Share → Save to Files”. The summary is designed to fit one A4 or letter page.

Do I have to answer all twelve questions?

No. Empty questions do not appear on the summary. The most important are location, intensity, onset, previous treatments and your questions.

Can I fill it in for a relative?

Yes. Answer the questions the way the person describes things, and go through the answers with them before the appointment.

Read more

Sources

A summary captures one moment. If you track your pain over weeks in the PainTrack app – free, with a few taps a day – PainTrack Pro turns it into a PDF doctor report built from your real history: summary, charts, medicines with intake log, body map and patterns.

The summary organises what you enter. It does not diagnose and does not replace medical advice. With warning signs or in an emergency, call your emergency number.