Foot Survey

1. Do you experience any pain in your feet, ankles, legs, knees, hips or back?*
- Yes
- No
2. Do you have any discoloured, thickened, damaged or sore nails?*
- Yes
- No
3. Do you have toes that claw, bunions or other foot deformities?*
- Yes
- No
4. Do you have any hard skin, corns, callous or other skin concerns?*
- Yes
- No
5. Do you have trouble finding footwear to fit your feet or footwear that is comfortable?*
- Yes
- No
Name*
Email*
Phone*
Untitled*
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