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1. How would you describe your current pain level? (0 = no pain, 10 = worst imaginable pain) 1. How would you describe your current pain level? (0 = no pain, 10 = worst imaginable pain) 1 2 3 4 5 6 7 8 9 10

2. Which best describes your pain pattern? 2. Which best describes your pain pattern? Constant and burning Comes in waves or flares Triggered by touch or temperature Mostly at night Other

3. Where is your pain located? 3. Where is your pain located? Face Chest Back Legs Arms Other

4. What makes your pain worse? 4. What makes your pain worse? Stress Movement Weather Clothing Touch Unknown

5. What helps relieve your pain? 5. What helps relieve your pain? Medication Prayer Breathwork Topical Creams Support from others Terrain practices (e.g., hydration, sleep, nutrition) Other

6. How often do you feel discouraged or hopeless due to your pain? 6. How often do you feel discouraged or hopeless due to your pain? Never Occasionally Weekly Daily

7. Do you feel supported in your healing journey? 7. Do you feel supported in your healing journey? Yes, deeply Somewhat Rarely Not at all

8. Which spiritual or emotional practices help you cope? 8. Which spiritual or emotional practices help you cope? Prayer Journaling Scripture Meditation Talking with others Nature walks Music Other

9. What does healing mean to you right now?

10. How has PHN affected your ability to… (Scale: 0 = no impact, 5 = severe impact) 10. How has PHN affected your ability to… (Scale: 0 = no impact, 5 = severe impact) Sleep Work Socialize Excercise Care for others

Sleep Sleep 0 1 2 3 4 5

Work Work 0 1 2 3 4 5

Socialize Socialize 0 1 2 3 4 5

Exercise Exercise 0 1 2 3 4 5

Care for others Care for others 0 1 2 3 4 5

11. Are you currently using any terrain-based healing tools? 11. Are you currently using any terrain-based healing tools? Yes No

11 B. If yes, which ones? 11 B. If yes, which ones? Breathwork Terrain Journaling PainBreak topical Supplements Support group Other

12. Did your PHN symptoms begin… 12. Did your PHN symptoms begin… Before COVID-19 (before March 2020) After COVID-19 (March 2020 or later) Unsure

13. Which of the following co-morbidities do you currently live with? 13. Which of the following co-morbidities do you currently live with? Diabetes Hypertension Autoimmune conditions Depression or anxiety Cardiovascular disease Chronic fatigue Other

14. What message would you share with others living with PHN?

15. Would you be open to sharing your story to help others? 15. Would you be open to sharing your story to help others? Yes, anonymously Yes, with my name Not at this time