A screenshot of a webform for an unidentified pain medication asking doctors to "Consider a patient for whom you would typically prescribe an immediate-release analgesic". On the right side of the form there is a photo of a woman with curly hair wearing a blue sleeveless blouse and a long gray skirt. She is standing with her hands clasped in front of her and is looking directly at the camera.
To the left of the photo there are five fields :
- Female
- Acute postsurgical
- Specialty (with 5 options listed)
- Source of acute pain
- Pain score
There is a Submit button at the bottom of the page.
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