Document a new health incident for your personal records and tracking

Episode Information

Episode Identification Information
Provide basic information to identify and timestamp this health episode.
Give this episode a memorable name for your records.
When did this episode begin or when did you first notice the symptoms?

searchEssential Information

Describe the symptoms or incident that brought you to fill out this form. Include what you were doing when it started.
Be specific about the location of symptoms. Note if the sensation moves or spreads to other areas.

Rate your overall pain level right now

Pain Scale: 0-10
0 = No pain • 10 = Worst possible pain
012345678910
1
Very mild discomfort
Minimal impact on daily activities
Describe the quality of the sensation - is it sharp, dull, throbbing, burning, etc.? What makes it better or worse?

rotate_rightCondition Severity Assessment

Use arrow keys or tab to navigate between severity levels. Press Enter or Space to select.
Select your current condition severity level above

historyContext & Actions Taken

analyticsCurrent Status & Next Steps

Offline Mode - Your data is saved locally and secure