"*" indicates required fields PCS Questionnaire Everyone experiences painful situations at some point in their lives. Such experiences may include headaches, tooth pain, joint or muscle pain. People are often exposed to situations that may cause pain such as illness, injury, dental procedures or surgery. We are interested in the types of thoughts and feeling that you have when you are in pain. Listed below are thirteen statements describing different thoughts and feelings that may be associated with pain. Using the scale, please indicate the degree to which you have these thoughts and feelings when you are…Name* First Last Email* I worry all the time about whether the pain will end*Not at allTo a slight degreeTo a moderate degreeTo a great degreeAll the timeI feel I can't go on*Not at allTo a slight degreeTo a moderate degreeTo a great degreeAll the timeIt's terrible and I think it's never going to get any better*Not at allTo a slight degreeTo a moderate degreeTo a great degreeAll the timeIt's awful and I feel that it overwhelms me*Not at allTo a slight degreeTo a moderate degreeTo a great degreeAll the timeI feel I can't stand it anymore*Not at allTo a slight degreeTo a moderate degreeTo a great degreeAll the timeI become afraid that the pain will get worse*Not at allTo a slight degreeTo a moderate degreeTo a great degreeAll the timeI keep thinking of other painful events*Not at allTo a slight degreeTo a moderate degreeTo a great degreeAll the timeI anxiously want the pain to go away*Not at allTo a slight degreeTo a moderate degreeTo a great degreeAll the timeI can't seem to keep it out of my mind*Not at allTo a slight degreeTo a moderate degreeTo a great degreeAll the timeI keep thinking about how much it hurts*Not at allTo a slight degreeTo a moderate degreeTo a great degreeAll the timeI keep thinking about how badly I want the pain to stop*Not at allTo a slight degreeTo a moderate degreeTo a great degreeAll the timeThere’s nothing I can do to reduce the intensity of the pain*Not at allTo a slight degreeTo a moderate degreeTo a great degreeAll the timeI wonder whether something serious may happen*Not at allTo a slight degreeTo a moderate degreeTo a great degreeAll the timeConsent* I agree to the Equanimity CPS LTD privacy policy in relation to the processing of my data.PhoneThis field is for validation purposes and should be left unchanged.
