painDETECT
21 reviews
21K+
Installs

Use our readymade template to create your painDETECT Questionnaire (PD-Q) for identifying neuropathic pain

Create your care assessments

PD-Q score Diagnosis
0-12 A neuropathic pain component is unlikely
13-18 Neuropathic pain can be present, but is uncertain
19-38 A neuropathic pain component is likely
  • navigate_next Prebuilt template with PD-Q scoring to assess the presence of neuropathic pain and measure its severity
  • navigate_next Patient-completed questionnaire that scores each of the pain symptoms as “0” (never) to “5” (very strongly)
  • navigate_next Real-time calculation of PD-Q Score and diagnosis based on the form responses
  • navigate_next Collect patient data and other sensitive healthcare data using our HIPAA compliant online assessment forms
  • navigate_next Compare the scores from the initial screening with that of the followup to track the progression of neuropathic pain
  • 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 would you assess your pain now, at this moment? 5
How strong was the strongest pain during the past 4 weeks? 7
How strong was the pain on average during the past 4 weeks? 6
Select the statement that best describes the course of your pain: Persistent pain with slight fluctuations
Does your pain radiate to other regions of your body? Yes
Do you suffer from a burning sensation (e.g., stinging nettles) in the marked areas? Slightly
Do you have a tingling or prickling sensation in the area of your pain (like crawling ants or electrical tingling)? Moderately
Is light touching (clothing, a blanket) in this area painful? Strongly
Do you have sudden pain attacks in the area of your pain, like electric shocks? Very Strongly
Is cold or heat (bath water) in this area occasionally painful? Never
Do you suffer from a sensation of numbness in the areas that you marked? Hardly Noticed
Does slight pressure in this area, e.g., with a finger, trigger pain? Slightly
PD-Q Score 20
Diagnosis A neuropathic pain component is likely
  • navigate_next Pre-populate patient details such as patient id, name, email etc in the PD-Q assessment form before sharing it with the patients
  • navigate_next Send an email invitation with a secure link for patients to complete their PD-Q assessment form prior to their visit
  • navigate_next Allow patients to save their progress and complete their PD-Q assessment form at a later time without losing any responses
  • navigate_next Set up an email template for your PD-Q assessment and automatically send invitation emails to multiple patients with ease
  • navigate_next Send a confirmation email to the patients with their PD-Q score, diagnosis, next steps when they submit their PD-Q assessment

Track patient responses in Google Sheets

A B C D E
1 Name Question Answer Score Total Score
2 John W Select the statement that best describes the course of your pain: Persistent pain with slight fluctuations 0 20
3 John W Does your pain radiate to other regions of your body? Yes 2 20
4 John W Do you suffer from a burning sensation (e.g., stinging nettles) in the marked areas? Slightly 2 20
5 John W Do you have a tingling or prickling sensation in the area of your pain (like crawling ants or electrical tingling)? Moderately 3 20
6 John W Is light touching (clothing, a blanket) in this area painful? Strongly 4 20
7 John W Do you have sudden pain attacks in the area of your pain, like electric shocks? Very Strongly 5 20
8 John W Is cold or heat (bath water) in this area occasionally painful? Never 0 20
9 John W Do you suffer from a sensation of numbness in the areas that you marked? Hardly Noticed 1 20
10 John W Does slight pressure in this area, e.g., with a finger, trigger pain? Slightly 2 20
  • navigate_next Export patient responses including the calculated PD-Q score and diagnosis to Google Sheets for easy record-keeping
  • navigate_next Export individual points for each pain symptom 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 pain symptoms
  • navigate_next Receive a copy of the response and the calculated PD-Q score by email whenever a patient submits their PD-Q 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 would you assess your pain now, at this moment?: 5
How strong was the strongest pain during the past 4 weeks?: 7
How strong was the pain on average during the past 4 weeks?: 6
Select the statement that best describes the course of your pain:: Persistent pain with slight fluctuations
Does your pain radiate to other regions of your body?: Yes
Do you suffer from a burning sensation (e.g., stinging nettles) in the marked areas?: Slightly
Do you have a tingling or prickling sensation in the area of your pain (like crawling ants or electrical tingling)?: Moderately
Is light touching (clothing, a blanket) in this area painful?: Strongly
Do you have sudden pain attacks in the area of your pain, like electric shocks?: Very Strongly
Is cold or heat (bath water) in this area occasionally painful?: Never
Do you suffer from a sensation of numbness in the areas that you marked? : Hardly Noticed
Does slight pressure in this area, e.g., with a finger, trigger pain?: Slightly
PD-Q Score: 20
Diagnosis: A neuropathic pain component is likely
PD-Q Score: 20
Diagnosis: A neuropathic pain component is likely
  • navigate_next Create a HIPAA compliant PD-Q 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 PD-Q form responses to Google Sheets and sending them on email
  • navigate_next Prepopulate patient details in PD-Q assessments by creating secure prefill links without exposing PHI
  • 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 27, 2023

5 stars

I am 100% a fan of this company. We use HIPAA compliant Google Forms and needed a way to collect signatures, the industry standard company is TOO expensive. I started using FormEsign and it worked perfectly. It lacked the ability to provide a pdf copy of the form after signature. This company worked with me help their product evolve into something that could benefit all future clients AND the end user. The team was polite, professional, kind, enthusiastic, and willing to make a change. This earned my loyalty. I will sing their praises. Good work, and thank you!

— Royal Bush

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 30, 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

More...
close