I am working on a questionnaire which is currently in a development stage as I am still seeking advice on how it can be best presented as a valid literacy test which can possibly be measured along with other pain questionnaires.

Any constructive feedback is therefore welcome.

If you are a referred patient please fill it in online via this page OR download / print out the form version below and fill it in prior to visiting the rest of the website and/or seeing me formally.

Please also fill out the other EPPOC form (these are standard forms for measuring the situation initially and then the progress afterwards) and bring this and the pain questionnaire form with you when you see me.

Otherwise, just test yourself and then look at the answers via the button at the bottom of this page.

It is my suspicion at this early stage in development that the lower the score on this test, the more vulnerable the situation is to a persistent +/- amplified pain outcome.

If you are already suffering this outcome, poor pain literacy may help explain how you got there, and optimising your understanding of your situation may help you on the pathway to a better outcome.

(NB: The test is just below. The answers and the science-based explanations for the answers are available via a link at the bottom of the page but please do the test first)

** The easiest way and my preference is that you fill in the test here below on an online form and submit it directly online (other options are provided below):

Fill out my online form.

The test in Adobe format


NB: You can fill it out by typing and clicking on the drop down menus on your computer first, then save it as a file and send it to:



Alternatively you can just print it out and use a pen like in the olden days ...

Pain questionnaire 29_11_15 for printing.pdf Pain questionnaire 29_11_15 for printing.pdf
Size : 278.313 Kb
Type : pdf

The following forms are also necessary for monitoring of progress and research purposes but at this stage are only available in a written format.

Once these are filled in please either scan and email to manager@brightonspinal.com.au, post them in or bring them in personally.

Standard EPPOC Questionnaires -->


InitialForm.pdf InitialForm.pdf
Size : 185.164 Kb
Type : pdf
FollowUpForm.pdf FollowUpForm.pdf
Size : 188.582 Kb
Type : pdf

Click the button above to access the answers.

The brief explanations offered are a work in progress

There is greater detail on the rest of the website.