Internal
Damage Pain Assessment
__________
Instructor:
mz menzchine
Name: ________
Date: _________
Condition
(if diagnosed):__________________
Please create
a hardcopy of this sheet before commencing
answering
the questions. Read each question
carefully,
then circle
the letter of the correct answer on the line
next to
it. When completed,
file the form in an appropriate
location
for future reference.
1. Is there
an absence of pain regarding the specified
internal
damage?
a. Yes
b. No
c. Other
[how do you quantify states not obvious to
the naked
eye? a shark-skinned touch...a lathering of
steelwool
words grating...a chilling slap to your present
sense of
space and time]
2. Does
the pain have a definable/recognizable
source (e.g
an open wound, tender spot, etc)
?
a. Yes
b. No
c. Maybe
[...once fleshfilled hormone sparks that now
rip through
your psychic skin and cerebral bones....]
3. Is the
pain constant?
a. Yes
b. No
c. Unsure
[is unseen pain the better option? Bear with
it - grit
and grind your pearly whites until they paint
your mouth
with red...bite or swallow your tensile
tongue...
and all the while just grimace and purr
and static
your insides with mellow shades of numb
...he won't
notice your frisking acting state...
you
will cushion all...no effect, no affect]
4. Is the
pain:
a. Mild
b. Moderate
c. Severe
[severely sever effective ties and bows
and learn
to live with graphic states of pain].
Thank you for participating.
