Wong on Web Archive
FACES Permission Form
Please complete this form online, then print. Sign and fax the completed form to:Natalie David
Global Rights Department
PO Box 800
Oxford OX5 1DX
Tel: 215-239-3804 (US) or (+44) 1865 843830 (UK)
Fax: (+44) 1865 853333 (UK)
Email: email@example.com or firstname.lastname@example.org
Permission is granted for use of the Wong-Baker FACES Pain Rating Scale subject to the stipulations listed below.
Brief word instructions: Point to each face using the words to describe the pain intensity. Ask the child to choose face that best describes own pain and record the appropriate number.
Original instructions: Explain to the person that each face is for a person who feels happy because he has no pain (hurt) or sad because he has some or a lot of pain. Face 0 is very happy because he doesn't hurt at all. Face 1 hurts just a little bit. Face 2 hurts a little more. Face 3 hurts even more. Face 4 hurts a whole lot. Face 5 hurts as much as you can imagine, although you don't have to be crying to feel this bad. Ask the person to choose the face that best desribes how he is feeling.
Rating scale is recommended for persons age 3 years and older.
Download FACES scale