Question Title * 1. How would you rate your pain intensity? 0 - No Pain 1 2 3 4 5 6 7 8 9 10 - Extreme Pain 0 - No Pain 1 2 3 4 5 6 7 8 9 10 - Extreme Pain Question Title * 2. I am seeing Dr. Smith today for: Low Back Pain Mid-Back Pain Neck Pain Headache General Wellness Maintenance Care Non-Musculoskeletal Condition Question Title * 3. Compared to your first visit to Dr. Smith for the condition you identified in question #2, your condition is? Completely Gone Much Better Moderately Better A Little Better About the Same A Little Worse Much Worse Next