ADDRESS

12200 N. Ambassador Drive, Suite 603
Kansas City, MO. 64163

PHONE

816-584-0444

Whiplash Injury Questionaire

WHIPLASH INJURY QUESTIONERRE:

If you have been injured in a car crash-What are the key questions that every good doctor should ask you!

Below is a sample of our normal questions for each injured area, along with possible sample answers.

Q: What is your chief complaint? A: Neck pain.

Q: Where does it hurt? A: Left side mid and lower neck.

Q: What is the quality of your pain? A: Tight and burning pain.

Q: What is the severity of your pain? A: Moderate to severe.

Q: What is the duration of your pain? A: Constant tightness with intermittent burning pain.

Q: What was the onset of your pain? A: Sudden after a car crash.

Q: What relieves your pain? A: Rest and ice.

Q: What aggravates your pain? A: Quick movement.

Q: Does your pain radiate? A: Yes into left trapezius and into left shoulder/arm.

Q: Does your pain interfere with your activities of daily living? A: Yes difficult raise my arm to wash my hair.

Q: Does your pain interfere with your work activities? A: Yes difficult to perform computer work.

 

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