Pain Assessment Body Map Intake: A Free Tool for Clinics
A body map pain assessment captures pain location, severity and type faster and more consistently than free text, and gives the practitioner a baseline to compare at the next visit.
- Mark pain regions on front and back body maps, with a 0-10 score per region
- Record pain type, onset, duration and aggravating or easing factors
- Brand the free Universal Plugins pain intake form with your clinic name, logo and booking link
- Optionally connect Gohighlevel so submissions create or update the contact
- Download one file and host it on your own website
With Cliniko, Jane App or Nookal synced two ways, the assessment feeds follow-up automation: confirmations, between-visit check-ins and recall for the same complaint months later.
Why a body map beats a text box
Asking a patient to describe where it hurts in writing produces vague answers. Asking them to mark it on a body map produces a picture the practitioner can read in seconds, including patterns - referred pain, bilateral symptoms, multiple sites - that a sentence usually omits.
Adding intensity ratings and duration alongside the map gives you severity and history in the same pass, so the first minutes of the appointment go to examination rather than establishing the basics.
Using it before the appointment
Send the form when the appointment is booked and remind once the day before, using the sequence that already confirms and reminds. Most patients complete it on a phone before they arrive, which means the practitioner opens the visit already informed and reception does not have to hand anything over at the desk.
Because it is branded with your clinic name, logo and booking link, it reads as part of your clinic rather than as a third-party tool.
Making it part of the record
Connect the form to Gohighlevel and the responses sit on the contact alongside the appointment detail synced from Cliniko, Jane App or Nookal. Follow-up can then reference the area treated and the practitioner seen, and a repeat assessment at the next visit gives you a simple before-and-after for the treatment plan.
The form is free to use: add your branding, share it as a link, embed it on your site, or download it as a standalone page you host yourself.