Pain log Use this scale to rate the severity of your pain.
No Pain	Mild Pain	Moderate Pain	Severe Pain	Worst Pain Imaginable
1	2	3	4	5	6	7	8	9	10

Time	Scale	Type of Pain	Activities causing pain	Symptom	Medicine or supplements
Day 1	Start: Stop:
Day 2
Day 3
Day 4
Day 5
Day 6
Day 7