Free Pain Disability Questionnaire (PDQ) Template – Download Now!
The Pain Disability Questionnaire (PDQ) is a simple yet effective template designed to assess how pain affects daily life. It helps healthcare professionals and patients measure the impact of chronic pain on activities like work, self-care, and social interactions.

Why Use the Pain Disability Questionnaire?
This questionnaire helps:
- Understand the effect of pain on daily activities.
- Measure functional limitations, not just pain intensity.
- Track progress over time to see how treatment is working.
Who Uses the PDQ?
- Doctors and therapists to assess pain-related disability.
- Patients to self-report how pain affects their daily life.
- Clinics and researchers for evaluating treatment outcomes.
Template Categories
California
General
How to Use the Pain Disability Questionnaire template?
- Download the free pain disability questionnaire template from this page by typing your email ID.
- Receive the template in your inbox directly.
- Answer the questions honestly based on how pain affects your activities.
- Share it with a healthcare provider to help guide treatment decisions.
Download the Free Pain Disability Questionnaire Template
Easily assess and track the impact of pain on daily life. Download your free PDQ template now and take control of your pain management!
Related Templates
Sample IME/QME Report Template
Sample IME/QME Report TemplateAn Independent Medical Examination (IME) report or a Qualified Medical Evaluation (QME) is a vital document used to provide an unbiased medical opinion in legal, insurance, or worker's compensation cases. These reports are diligently...
Free DWC Form PR-4: Primary Treating Physician’s P&S Report Template
Free DWC Form PR-4: Primary Treating Physician’s P&S Report TemplateThe DWC form PR-4 or the Primary Treating Physician’s Permanent and Stationary Report (P&S Report) is an important document in California workers' compensation cases, submitted when an...
Request for Factual Correction of an Unrepresented Panel QME Report (QME Form 37)
Request for Factual Correction of an Unrepresented Panel QME Report (Form 37) The Request for Factual Correction of an Unrepresented Panel QME Report (QME Form 37) is an essential document in California workers' compensation cases. It allows an unrepresented injured...
Free DWC Form RFA to Request Authorization for Medical Treatment
Free DWC Form RFA to Request Authorization for Medical TreatmentThe DWC Form RFA or the Request Authorization for Medical Treatment Form is used in California workers' compensation cases to request prior approval from an insurance company or claims administrator...
QME Form 104 – Reappointment Application as a Qualified Medical Evaluator
QME Form 104 – Reappointment Application as a Qualified Medical EvaluatorThe Reappointment Application as Qualified QME (QME Form 104) is a much-required document for physicians in California seeking to renew their position as a Qualified Medical Evaluator (QME). This...
QME Replacement Panel Request Form-Download for Free!
QME Replacement Panel Request Form-Download for Free!The Replacement Panel Request Form is a significant document in California’s workers' compensation system. It allows parties involved in a claim to request a new panel of Qualified Medical Examiners (QMEs) when the...
Download QME Form 105 for Free – Complete Your QME Panel Request
Download QME Form 105 for Free – Complete Your QME Panel RequestThe Request for Qualified Medical Evaluator (QME) Panel Form 105 is a crucial document used in California workers' compensation cases to request a panel of three Qualified Medical Evaluators (QMEs). This...
QME Notice of Unavailability (Form 109) – Free Template Download
QME Notice of Unavailability (Form 109) – Free Template DownloadThe QME Notice of Unavailability (Form 109) is an essential form used in California workers' compensation cases to notify the Division of Workers' Compensation (DWC) Medical Unit when a Qualified Medical...
Download Free QME Form 121 – Protection of Mental Health Record
Download Free QME Form 121 – Protection of Mental Health RecordThe QME Form 121 is an important document used in California workers’ compensation cases to ensure the confidentiality of an injured worker’s mental health records. A Qualified Medical Evaluator (QME) must...
Free QME Form 120 Template – Download Now!
Free QME Form 120 Template – Download Now!The Voluntary Directive for Alternate Service of Medical-Legal Evaluation Report on Disputed Injury to Psyche (Form 120) is used in California workers' compensation cases when an injured worker wants their psychological injury...