Personal Details
Medical History
Pain Assessment
Body Chart
Body Chart
Question 1
Personal Details
Question 2
Body Metrics
Question 3
In case a Free T-shirt has to come your way, tell us where to send it
Question 4
What is your current employment status?
Question 5
How would you describe your daily lifestyle?
Question 6
How active are you in terms of exercise or sports?
Question 7
What is your profession?
Question 8
How would you describe your current work-life balance?
Question 9
How often do you take breaks during your regular day?
Question 10
How many hours of sleep do you usually get on a typical night?
Question 11
How often do you get up and move around during your workday?
Question 12
What’s your biggest challenge in staying active?
Question 13
If you had an extra hour in your day, what would you do with it?
Question 14
On a scale of 1-10, how motivated are you to improve your work-life balance and activity levels?
Question 15
What’s one thing you could change today to feel more balanced or active?
Question 7
Which best describes your current activity level?
Question 8
How often do you take breaks throughout your day?
Question 9
How many hours of sleep do you usually get on a typical night?
Question 10
What’s your biggest challenge in staying active?
Question 11
If you had an extra hour in your day, what would you do with it?
Question 12
On a scale of 1-10, how motivated are you to improve your activity levels?
Question 13
What’s one thing you could change today to feel more balanced or active?
Question 1
Have you had any surgeries before?  If YES, please mention the date and nature of the surgeries?*
The surgery may be related to any part of the body within the last year or since the onset of your symptoms.
Question 2
Do you have any allergies or relevant medical history that we should be aware of?
Question 3
What’s your primary goal with our program?
Example: I’d like to return to playing badminton, running pain-free, doing weight training, etc
Question 4
Do you have any chronic health conditions? If YES, please specify.*
Like Diabetes, hypertension, Thyroid, PCOD etc
Question 5
How much control do you feel you have over your recovery?*
Question 6
Has the injury impacted your mental/emotional health?*
Question 7
How do you feel about your current injury/recovery state?*
Question 8
How much impact has the injury had on your way of living?
Question 9
How many health providers have you tried before approaching Granimals?
Question 10
Have you undergone any tests for this current injury or concern? If YES, please upload the reports here.
Like., X-ray, MRI, CT scan)
Select a file or drag and drop here
Max file size 10MB.
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Question 1
How INTENSE is your pain right now?
On a scale of 0 to 10, rate how strong or overwhelming the pain feels in the moment
Mild Pain
Moderate pain
Severe pain
Most Intense
pain imaginable
1
2
3
4
5
6
7
8
9
10
No pain
Intense Pain
Question 2
Describe how SHARP the pain feels.
The sharp pain usually feels like a stabbing or piercing sensation. Rate how sharp or piercing your pain is on a scale of 0 to 10.
Mild Pain
Moderate pain
Severe pain
Most Intense
pain imaginable
1
2
3
4
5
6
7
8
9
10
No Sharp
Extremely Sharp
Question 3
Describe how HOT the pain feels.
Some pain may feel burning as if heat is radiating from the affected area. Rate how much of a burning or fiery sensation you experience.
Mild Pain
Moderate pain
Severe pain
Most Intense
pain imaginable
1
2
3
4
5
6
7
8
9
10
Not Hot
Burning
Question 4
Describe how DULL the pain has felt over the past week.
Dull pain is often persistent and achy, like a low-level constant discomfort. Rate how dull or achy your pain has been.
Mild Pain
Moderate pain
Severe pain
Most Intense
pain imaginable
1
2
3
4
5
6
7
8
9
10
Not Dull
Very Dull
Question 5
Describe how COLD the pain feel
Sometimes, pain can feel icy or cold, as though the affected area is freezing. Rate how much your pain feels cold or chilled.
Mild Pain
Moderate pain
Severe pain
Most Intense
pain imaginable
1
2
3
4
5
6
7
8
9
10
No Pain
Burning
Question 6
Is the area of pain SENSITIVE to touch?
When touched, does the area of pain feel hypersensitive? Rate how sensitive or painful the touch feels in the affected area.
Mild Pain
Moderate pain
Severe pain
Most Intense
pain imaginable
1
2
3
4
5
6
7
8
9
10
Not Sensitive
Very Sensitive
Question 7
Does the pain area feel TENDER on touch?
Tenderness can make even gentle touch uncomfortable or painful. Rate how tender the area feels on a scale of 0 to 10.
Mild Pain
Moderate pain
Severe pain
Most Intense
pain imaginable
1
2
3
4
5
6
7
8
9
10
Not Tender
Most Tender
Question 8
How ITCHY does your pain feel?
Pain can sometimes have an itchy component, as if you need to scratch the affected area. Rate how itchy your pain feels
Mild Pain
Moderate pain
Severe pain
Most Intense
pain imaginable
1
2
3
4
5
6
7
8
9
10
Not Itchy
Very Itchy
Question 8
How much your pain has felt like it has been SHOOTING over the past week?
Shooting pain can feel like sudden, sharp zaps or jolts. Rate how often and intense this shooting or electric pain feels.
Mild Pain
Moderate pain
Severe pain
Most Intense
pain imaginable
1
2
3
4
5
6
7
8
9
10
Not Shooting
Zapping
Question 9
How NUMB has your pain felt over the past week?
Numbness may feel like a lack of sensation or a dull, tingly deadness. Rate how numb your pain has felt.
Mild Pain
Moderate pain
Severe pain
Most Intense
pain imaginable
1
2
3
4
5
6
7
8
9
10
Not Numb
Most Numb
Question 10
How has your pain been TINGLING over the past week?
Tingling pain feels like pins and needles or a prickly sensation. Rate how much tingling you've felt.
Mild Pain
Moderate pain
Severe pain
Most Intense
pain imaginable
1
2
3
4
5
6
7
8
9
10
No Tingling
Most Tingling
Question 11
How CRAMPING your pain has felt over the past week?
Cramping pain often feels like muscle tightening or spasms. Rate how much cramping sensation you’ve felt.
Mild Pain
Moderate pain
Severe pain
Most Intense
pain imaginable
1
2
3
4
5
6
7
8
9
10
Not Cramping
Most Cramping
Question 12
How RADIATING your pain felt over the past week?
Radiating pain spreads from one area to another like a wave of discomfort. Rate how much your pain has radiated.
Mild Pain
Moderate pain
Severe pain
Most Intense
pain imaginable
1
2
3
4
5
6
7
8
9
10
Not Radiating
Most Radiating
Question 13
How THROBBING was your pain over the past week?
Throbbing pain feels like rhythmic pulsing or pounding. Rate how intense this sensation has been.
Mild Pain
Moderate pain
Severe pain
Most Intense
pain imaginable
1
2
3
4
5
6
7
8
9
10
Not Throbbing
Most Throbbing
Question 14
How ACHING has your pain felt over the past week?
Aching pain is often a deep, persistent soreness. Rate how much aching you’ve felt.
Mild Pain
Moderate pain
Severe pain
Most Intense
pain imaginable
1
2
3
4
5
6
7
8
9
10
Not Throbbing
Most Throbbing
Question 15
How HEAVY your pain has felt over the past week?
Some pain feels like a weight pressing down or a sense of heaviness in the area. Rate how heavy your pain has felt.
Mild Pain
Moderate pain
Severe pain
Most Intense
pain imaginable
1
2
3
4
5
6
7
8
9
10
Not Heavy
Most Heavy
Question 16
Now that we have squared what kind of pain you have felt over the past week,
it’s time to tell us how UNPLEASANT your pain has been over the past week.
On a scale of 0 to 10, rate how uncomfortable or unbearable your pain has been overall
Mild Pain
Moderate pain
Severe pain
Most Intense
pain imaginable
1
2
3
4
5
6
7
8
9
10
Not Unpleasant
Intolerable
Please indicate the areas of your body where you are experiencing pain by clicking on them
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