International Foundation for Performing Arts Medicine  

Help Us Help You

To better understand your perception and understanding of pain you are being asked for a few minutes of your time to answer the following questions.  You identity will be kept completely confidential and will only be used by the International Foundation for Performing Arts Medicine (IFPAM) so that you can be contacted if we have any further questions regarding your answers.  IFPAM does not share, buy, or sell any information.  Please complete the sentences below as best you can by circling the answer that matches your understanding of pain, the best.  Please type an 'x' after only ONE answer.  When you are finished answering all questions, kindly copy the questionnaire and paste it into an email message and send it to IFPAM at ifpam@optonline.net  Thank you.

1.            I usually can tell the difference between “good” pain and “bad” pain.

                a.            Yes 
                b.            No 

2.            Good pain is when I have worked a muscle into soreness but it is only from exercise or activity. 
               There is NO damage in the muscle.

                a.            Yes
                b.            No 

3.            Bad pain is when I have worked a muscle too hard and if I continue I will:

                a.            Get stronger    
                b.            Get stronger but might hurt myself if I continue to work the muscle
                  c.            Find I can work through the pain because I know the pain will go away
                d.            Probably hurt myself if I continue to work the muscle

 

4.            When I have some pain I believe:

                a.            Something is wrong and I must stop what I am doing until I am pain free again    
                b.            My body is trying to warn me that something wrong is going to happen if I don’t stop what I 
                               am doing and continue at a later time when I feel fine
                c.            My body is trying to warn me that something wrong is going to happen if I don’t stop what I 
                               am doing but I won’t stop anyway


Name: ___________________________________________

Telephone (home): _________________________________

Cell: _____________________________________________

Work: ____________________________________________

May we contact you if we have any further questions?

a.            Yes
b.            No

Website Builder