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Foot Pain Assessment

1 / 5

Have problems with your feet or ankles ever prevented you from participating in sports/leisure activities?*

2 / 5

Have problems with your feet or ankles ever prevented you from participating in work activities?

3 / 5

Have you ever received medical treatment for problems with your feet and/or ankles?

4 / 5

Do you regularly wear heels two inches or higher?*

5 / 5

What types of exercise do you engage in or plan to engage in? (check all that apply)

Thank you for taking the Foot Pain Assessment. 

To have your results reviewed by a health care representative please submit the following information.

Your score is

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