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Spinal Pain Diagram

Although not essential, it is very helpful prior to a new patient appointment to have completed a spinal pain diagram. It gives a good snapshot in time of your pain experience and information about the probable source of the pain you are experiencing.


Please follow the below instructions:

(1) download the below picture onto a known location on your device and;

(2) Draw where you are experiencing the usual and more constant pain in RED and highlight any intermittent, on and off shooting pain with BLUE

either edit it in a program on your device (e.g. paint), save


visit an online editable drawing site such as - on this website, one can import the pain diagram from the location you have saved it on your device by clicking the second icon to the right of the Kleki symbol and selecting the pain diagram image. Once your diagram is completed please either save to your device ready to send OR click the share button (fourth icon to the right of the Kleki icon), select your preferred mailing service and send.


(3) send or share saved file to stating your name and date of birth so we can identify and attach to your file;

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