Pain by activity

  • Eating
  • Being moved
  • Using the bathroom
  • Getting dressed
  • Lying in bed

Did your child have pain or discomfort during any other activity not listed above?

Yes
No

Both answers matter equally — there are no wrong responses.

What this question means

This asks about pain during activities other than the ones already listed.

Yes

There was pain during another activity not shown above

No

No pain during any other activity