Face, Legs, Activity, Cry, Consolability Behavioral Pain Scale
22 reviews

Use our readymade template to create your FLACC Behavioral Pain Scale

Create your care assessments

FLACC score Level of Pain Proposed treatment
0 Relaxed and comfortable May not need treatment
1-3 Mild discomfort Watchful waiting
4-6 Moderate pain Consider medication
7-10 Severe discomfort/pain Immediate initiation
  • navigate_next Prebuilt template with FLACC scoring to assess the presence of pain and measure its severity
  • navigate_next 5-item questionnaire that scores each of the 5 criteria as “0” (relaxed and comfortable) to “2” (severe discomfort/pain)
  • navigate_next Real-time calculation of FLACC Score and pain level based on the form responses
  • navigate_next Collect patient data and other sensitive healthcare data using our HIPAA compliant online assessment forms
  • navigate_next Compare the scores from the initial screening with that of the followup to track the progression of pain
  • navigate_next Easily create responsive forms that allow patients to complete their assessments on any device at any time

Collect responses from your patients

Patient ID 1004
Patient Name John W
Patient Email johnw@ymail.com
Patient Phone Number 0987654321
Face Frequent to constant quivering chin, clenched jow
Legs Kicking or legs drawn up
Activity Arched, rigid or jerking
Cry Crying steadily, screams, sobs, frequent complaints
Consolability Difficult to console or comfort
FLACC Score 10
Level of Pain Severe discomfort/pain
  • navigate_next Pre-populate patient details such as patient id, name, email etc in the FLACC assessment form before sharing it with the patients
  • navigate_next Send an email invitation with a secure link for patients to complete their FLACC assessment form prior to their visit
  • navigate_next Allow patients to save their progress and complete their FLACC assessment form at a later time without losing any responses
  • navigate_next Set up an email template for your FLACC assessment and automatically send invitation emails to multiple patients with ease
  • navigate_next Send a confirmation email to the patients with their FLACC score, diagnosis, next steps when they submit their FLACC assessment

Track patient responses in Google Sheets

1 Name Question Answer Score Total Score
2 John W Face Frequent to constant quivering chin, clenched jow 2 10
3 John W Legs Kicking or legs drawn up 2 10
4 John W Activity Arched, rigid or jerking 2 10
5 John W Cry Crying steadily, screams, sobs, frequent complaints 2 10
6 John W Consolability Difficult to console or comfort 2 10
  • navigate_next Export patient responses including the calculated FLACC score and pain level to Google Sheets for easy record-keeping
  • navigate_next Export individual points for 5 criteria to Google Sheets for data manipulation and analysis for comprehensive insights
  • navigate_next Use pre-built reports to easily keep track of patient progress over time and monitor changes in their pain symptoms
  • navigate_next Receive a copy of the response and the calculated FLACC score by email whenever a patient submits their FLACC assessment
  • navigate_next Use data in Google Sheets to integrate with external EHR systems for seamless data transfer

HIPAA compliance

Patient ID: 1004
Patient Name: ******
Patient Email: ******
Patient Phone Number: ******
Face: Frequent to constant quivering chin, clenched jow
Legs: Kicking or legs drawn up
Activity: Arched, rigid or jerking
Cry: Crying steadily, screams, sobs, frequent complaints
Consolability: Difficult to console or comfort
FLACC Score: 10
Level of Pain: Severe discomfort/pain
FLACC Score: 10
Level of Pain: Severe discomfort/pain
  • navigate_next Create a HIPAA compliant FLACC assessment form to safely collect, store and access patient responses
  • navigate_next Mark fields as Protected Health Information (PHI) to secure sensitive patient data and limit access to PHI
  • navigate_next Automatically mask PHI fields when exporting FLACC form responses to Google Sheets and sending them on email
  • navigate_next Prepopulate patient details in FLACC assessments by creating secure prefill links without exposing PHI
  • navigate_next Limit access to patient data only for authorized personnel and minimize the risk of data breaches

These reviews are reproduced without modification from Google Workspace Marketplace.

July 27, 2023

5 stars

I am 100% a fan of this company. We use HIPAA compliant Google Forms and needed a way to collect signatures, the industry standard company is TOO expensive. I started using FormEsign and it worked perfectly. It lacked the ability to provide a pdf copy of the form after signature. This company worked with me help their product evolve into something that could benefit all future clients AND the end user. The team was polite, professional, kind, enthusiastic, and willing to make a change. This earned my loyalty. I will sing their praises. Good work, and thank you!

— Royal Bush

July 23, 2023

5 stars

I am not tech savvy. I chose formesign to help create registration links for clients. Vipid has been great in assisting me. He goes above and beyond. My company now has moved from the stone age to modern age through the ability to use this feature. Of the many features I am impressed with, the ability to update a form without needing to regenerate a link is amazing. I often make mistakes and that ability allows me to fix mistakes without needing to change everything. Thank you!!!

— Sol Evans

October 31, 2023

5 stars

We needed a way to create forms with e-signatures and this app made it very easy. Support is also very quick and always helpful. Cannot recommend enough!

— Chris Henesy

February 16, 2024

1 stars

Does not work

— Myles Sicuro

July 12, 2023

5 stars

It very friendly to used. I love it. For my case multiple signature needed. it's supporting

— Senthil Kumar

November 27, 2023

5 stars

Yeah this is good for all

— luqman khan

July 10, 2023

5 stars

We were looking for a way to have a signature option in our form. Formesign addon allowed us to collect signatures for the acknowledgment and consent forms. It was simple and easy to setup. Very useful addon for google forms.

— Joan S