My Pain Relief Doc

          World Leader in Chronic Pain Relief and Treatment

 

 

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chronic pain relief, fibromyalgia treatment

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PRISM TOPICAL GEL FEEDBACK FORM

 

 

Please answer the following questions about your experience with the PRISM (Pain Relief Integrating Sensation and Movement) line of prescription, topical pain relievers. You can fax this page to (949) 266-8210 or mail it to P.O. Box 6599, Irvine, CA 92616. For questions, you can call (877) 545-7272. 

 

Which gel did you use?  NEURELIEF    MYOMEDIC   GYM GEL   FIBRO FREEZ    

 

On a scale of 0 (none) to 100 (worst possible), what was your pain level at the application site immediately before applying the topical gel?

 

On the 0-100 scale above, what was the lowest pain level you achieved at the application site within two hours after applying the gel? 

 

On the 0 (none) to 100 (worst possible) scale, what was your average pain level 30 to 90 minutes after applying the gel?

 

If you received pain relief from the gel, for how long did you receive even a little pain relief?
 

Comments? 
 

 

At your best pain relief, what percentage of increased activity was achieved in the application areas?

 

Comments?

 

At your best pain relief, what was the percentage improvement in your overall activity?

 

Comments?
 

 

What sensations did you notice at the application site within 1-120 minutes after topical application?

 

 

Did you notice any side effects, other than in the application site, 1-120 minutes after applying?
                                     Yes            No

 

If your answer was yes, what were the side effects?

 

 

On a scale of 0 (none) to 100 (worst possible), how unpleasant were any sensations or side effects?

 

Comments:

 

 

 

If you have already used multiple applications of gel over time, did the amount of pain relief from each successive application seem to be generally more, less, or the same over time?

 

Felt more pain relief           Felt less pain relief                     Felt the same as before

 

Comments?

 

Overall, was this topical pain reliever worth the money it cost you to buy it?

                                    Yes              No    

 

If the answer was no, why not?
 

 

Do you have any other feedback for us about your topical gel experience? 
 

 

 

 

 

 

 

 

 


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