Coronavirus alert

Please note there are currently no face-to-face appointments being held. Contact 01305 363019 if you require assistance (currently the only phone number in operation). Check if you have Coronavirus sypmtoms at the NHS 111 website.

Personal Information Questionnaire

If you have any difficulty in filling this form please call us on 01305 213040 or email us at dhc.dorset.cps@nhs.net.

  1. Personal Information
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  2. Occupational Experiences
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  3. About Your Pain
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  4. The Four Pillars
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  5. Treatments
    1. Current medication 1
    2. Past medication 1
    3. Physiotherapy
      Exercise / leisure centre
      Healthy Back Programme
      Expert Patient Programme
      IAPT / Talking Therapies
      TENS
      Acupuncture
      DOTS / OMS
      Injection Therapy
      Substance Misuse Referral
      Private Interventions
      Other intervention 1
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  6. Thoughts and Feelings
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  7. Living with pain
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