Growing Pains Questionnaire Growing Pains Questionnaire Name* First Just so we know who were are chatting to, can you please fill in the following (no one is stealing, no one is sending your information to nasty foreign call centres)Has your child woken at night with pain in their?* Legs Ankles Feet How long has your child been suffering from this problem* A month Between two and six months Between six and 12 months Longer than 12 months on and off All their life When did it last occur?* Last 7 days Last 14 days 1 month ago Longer than 3 months ago Longer than 6 months ago How often is it occurring?* 1-2 times a week or more Weekly 2-3 times a month Occasionally How old is your child?* 0-3 3-6 6-9 9-12 12-15 15-18 Does your child?* Get tired quickly from activity Avoid activity / sport Asked to be picked up regularly (Younger kids) Like to be put in stroller or shopping trolley Get tired quickly from walks with the family or playing together Have you taken them to see another health practitioner with limited or no success;* Yes No Do they have pain during or after activity?* During After Both (OUCH!)
