This brief assessment helps us recommend the right combination of therapies from our pain recovery protocol — built around five evidence-informed modalities that work together to relieve pain and restore function.
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5–7 minutes
Short, focused questions about your pain, history, and goals.
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Personalized plan
Recommendations tailored to where, how, and why you hurt.
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No commitment
You'll receive a recovery roadmap to discuss at your consultation.
Important: This assessment is for planning purposes and is not a medical diagnosis. If you're experiencing severe pain, recent significant injury, loss of bladder or bowel control, or progressive weakness, please contact us or seek medical care directly.
About You
Let's start with a few details.
So we can prepare your recommendations and follow up.
Pain Location
Where do you experience pain?
Select all areas that apply. You can choose more than one.
Pain Intensity
How would you rate your pain right now?
0 means no pain at all. 10 means the worst pain you can imagine.
No painWorst imaginable
At its worst over the past two weeks?
Pain can come and go — we want to capture how bad it gets.
No painWorst imaginable
Pain Quality
What does your pain feel like?
Select all that apply.
When is your pain worst?
Choose the option that best describes your typical pattern.
History
How long have you had this pain?
Did your pain start with a specific event?
Functional Impact
How is pain affecting your daily life?
Select everything you've been struggling with.
Quick Safety Check
Are any of these true for you?
If none apply, that's perfectly fine — just leave them blank.
What You've Tried
Have you tried any of these for your pain?
This helps us avoid repeating what hasn't worked and build on what has.
Your Goals
What does success look like for you?
Select your top priorities.
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Provider Review Recommended
Let's see you in person first.
Based on a few things you mentioned, our team would like to evaluate you directly before recommending a recovery protocol. Some symptoms warrant a thorough provider exam to rule out conditions that need different care than our pain program is designed for.
This isn't necessarily cause for alarm — it's simply the safe and responsible next step. Your provider can determine the right path forward.
If your symptoms are severe
Loss of bladder or bowel control, sudden severe weakness, or numbness in the saddle area can be medical emergencies. Please go to the nearest emergency department right away rather than waiting for a consultation.
Your responses have been saved and will be shared with your provider before your visit.
Your Personalized Plan
Welcome to recovery, friend.
Primary Pain Area
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Pain Level (Worst)
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Duration
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Recommended Modalities
Your BeaWell pain recovery protocol.
Next Step
Schedule your pain consultation.
We'll review your assessment together, refine your protocol, and map out a recovery timeline. Most patients see meaningful change within their first 4–6 weeks of consistent treatment.
