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SINCE THE LAST visit at this clinic: My WORST Pain score: 0 1 2 3 4 5 6 7 8 9 10 My LEAST Pain score: 0 1 2 3 4 5 6 7 8 9 10 My USUAL Pain score: 0 1 2 3 4 5 6 7 8 9 10 SINCE THE LAST visit at this clinic: My pain is: I am sleeping: I am functioning: My Medication use is: Better Better.

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