Free Foot Care Assessment

 

Welcome to the Canyon Oaks Foot and Ankle Free Foot Care Assessment. Answer the following questions and click the button below. Once you have completed the quiz, your points will be tallied and your overall foot and ankle health will be determined.

 

Full Name
Email
Phone Number
How much time do you spend on your feet each day?
How old are you?
Which one of the following statements describes your current body weight?
Have problems with your foot or ankle ever prevented you from participating in sports or leisure?
Have problems with your foot or ankle ever prevented you from working?
Have you ever received medical treatment for chronic foot or ankle problems?
Do you regularly wear heels two inches or higher?
What types of exercise do you engage in? (please select all that apply)
Do you wear the appropriate shoes for activities you engage in?
Do you experience foot or ankle pain when walking or exercising?
Do you exercise in shoes over a year old?
Do you stretch before exercise?
Do you have diabetes?
Do you ever experience numbness or burning in your feet?
Have a family history of diabetes?
Please mark all that apply

By providing a telephone number and submitting the form you are consenting to be contacted by SMS text message. Message and Data Rates may apply. You can STOP messaging by sending STOP and get more help by sending HELP.