Neuropathic Pain Scale
22 reviews
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Use our readymade template to create your Neuropathic Pain Scale (NPS) for assessing neuropathic pain

Create your care assessments

NPS score Pain Severity
0-30 Mild
31-70 Moderate
71-110 Severe
  • navigate_next 11-item questionnaire that scores each item on a scale of 0 to 10
  • navigate_next Real-time calculation of NPS Score based on the form responses
  • navigate_next Collect patient data and other sensitive healthcare data using our HIPAA compliant online assessment forms
  • navigate_next Easily create responsive forms that allow patients to complete their assessments on any device at any time

Collect responses from your patients

Patient ID 1004
Patient Name John W
Patient Email johnw@ymail.com
Patient Phone Number 0987654321
Doctor's Name Dr. Smith
Location New York
How intense is the pain? 5
How sharp is the pain? 4
How hot is the pain? 3
How dull is the pain? 2
How cold is the pain? 1
How sensitive is the skin to light touch? 6
How itchy is the pain? 7
How unpleasant is the pain? 8
If the pain is deep, how intense is the deep pain? 9
If the pain is on the surface, how intense is the surface pain? 10
What is the time quality of the pain? Background pain present all the time, with occasional flare-ups (breakthrough pain)
NPS score 55
  • navigate_next Allow patients to save their progress and complete their NPS assessment form at a later time without losing any responses
  • navigate_next Set up an email template for your NPS assessment and automatically send invitation emails to multiple patients with ease
  • navigate_next Send a confirmation email to the patients with their NPS score, diagnosis, next steps when they submit their NPS assessment

Track patient responses in Google Sheets

A B C D E
1 Name Question Answer Score Total Score
2 John W How intense is the pain? 5 5 55
3 John W How sharp is the pain? 4 4 55
4 John W How hot is the pain? 3 3 55
5 John W How dull is the pain? 2 2 55
6 John W How cold is the pain? 1 1 55
7 John W How sensitive is the skin to light touch? 6 6 55
8 John W How itchy is the pain? 7 7 55
9 John W How unpleasant is the pain? 8 8 55
10 John W If the pain is deep, how intense is the deep pain? 9 9 55
11 John W If the pain is on the surface, how intense is the surface pain? 10 10 55
  • navigate_next Export patient responses including the calculated NPS score to Google Sheets for easy record-keeping
  • navigate_next Export individual points for each item to Google Sheets for data manipulation and analysis for comprehensive insights
  • navigate_next Use pre-built reports to easily keep track of patient progress over time and monitor changes in their neuropathic pain symptoms
  • navigate_next Receive a copy of the response and the calculated NPS score by email whenever a patient submits their NPS assessment
  • navigate_next Use data in Google Sheets to integrate with external EHR systems for seamless data transfer

HIPAA compliance

Patient ID: 1004
Patient Name: ******
Patient Email: ******
Patient Phone Number: ******
Doctor's Name: Dr. Smith
Location: New York
How intense is the pain?: 5
How sharp is the pain?: 4
How hot is the pain?: 3
How dull is the pain?: 2
How cold is the pain?: 1
How sensitive is the skin to light touch?: 6
How itchy is the pain?: 7
How unpleasant is the pain?: 8
If the pain is deep, how intense is the deep pain?: 9
If the pain is on the surface, how intense is the surface pain?: 10
What is the time quality of the pain?: Background pain present all the time, with occasional flare-ups (breakthrough pain)
NPS score: 55
NPS score: 55
  • navigate_next Create a HIPAA compliant NPS assessment form to safely collect, store and access patient responses
  • navigate_next Mark fields as Protected Health Information (PHI) to secure sensitive patient data and limit access to PHI
  • navigate_next Automatically mask PHI fields when exporting NPS form responses to Google Sheets and sending them on email
  • navigate_next Limit access to patient data only for authorized personnel and minimize the risk of data breaches

These reviews are reproduced without modification from Google Workspace Marketplace.

July 23, 2023

5 stars

I am not tech savvy. I chose formesign to help create registration links for clients. Vipid has been great in assisting me. He goes above and beyond. My company now has moved from the stone age to modern age through the ability to use this feature. Of the many features I am impressed with, the ability to update a form without needing to regenerate a link is amazing. I often make mistakes and that ability allows me to fix mistakes without needing to change everything. Thank you!!!

— Sol Evans

February 16, 2024

1 stars

Does not work

— Myles Sicuro

October 31, 2023

5 stars

We needed a way to create forms with e-signatures and this app made it very easy. Support is also very quick and always helpful. Cannot recommend enough!

— Chris Henesy

July 12, 2023

5 stars

It very friendly to used. I love it. For my case multiple signature needed. it's supporting

— Senthil Kumar

November 27, 2023

5 stars

Yeah this is good for all

— luqman Khan

July 10, 2023

5 stars

We were looking for a way to have a signature option in our form. Formesign addon allowed us to collect signatures for the acknowledgment and consent forms. It was simple and easy to setup. Very useful addon for google forms.

— Joan S

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