Pain Map (see link below) contains two pages that you can print out and complete. The first is a Numeric Pain Intensity Scale. This will help to quantify your symptoms. Any symptoms that consistently run at a level of 5 or above should be discussed with your physician. The second page is a diagram of a woman which you can use to draw in the areas of pain. Feel free to add notes as to the characteristics of the pain. This information should help relate your situation to others. I would also suggest dating these forms for future reference.

Pain Map
(Click Above to download a PDF File)