1. Do you have pain in your feet or ankles? a. Yes b. No
2. Have you talked to your general doctor about your condition or pain? a. Yes b. No
3. Do you want to avoid surgery if at all possible? a. Yes b. No
4. Do you want a foot specialist who will educate you on your options, rather than one who simply dictates treatment? a. Yes b. No
5. Do you want your foot and ankle specialist to have extensive training and experience in both surgical and nonsurgical treatments? a. Yes b. No
6. Have you had foot or ankle surgery in the past? a. Yes b. No
7. Is your foot or ankle pain affecting your daily life? a. Yes b. No
8. Do you have diabetes? a. Yes b. No
9. Have you been living with foot or ankle pain or another foot or ankle condition for more than 6 months? a. Yes b. No
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