SYMPTOM CHECKLIST Quiz Phone Best Phone # to Reach you at Email What is the primary reason for your appointment ? Your feet are the foundation of your health. Any problem with them can affect your whole body. And in some cases, they provide early warning signs of diabetes, circulation problems and other health issues. The earlier you discover any condition, the better your chances are for managing it. Does foot pain prevent you from doing your favorite activity? Yes No Do you have chronic pain from prior injury or foot surgery? Yes No Do you have pain in the ball of your foot? Yes No Are you living with diabetes? Yes No Do you have burning or tingling in your legs or feet? Yes No Do you have leg or foot cramps with activity or at rest? Yes No Does your heel hurt when you get up in the morning or after sitting for a while? Yes No Do you have bunions or hammertoes that interfere with walking? Yes No Does it feel like you are walking on rocks or marbles? Yes No Are your toenails discolored, ingrown or have fungus? Yes No Would you like to schedule an appointment with one of our CiC podiatrists? Yes No If answered “yes” to any of these questions, or your feet are preventing you from going out as often as you’d like or are keeping you from doing your best at work, be sure to talk to your doctor about it at your visit. DO YOU NEED TO SEE ONE OF OUR DOCTORS? SAME DAY & NEXT DAY APPOINTMENTS AVALIBLE: reCAPTCHA If you are human, leave this field blank. Submit YOU DON’T HAVE TO SUFFER FROM FOOT PAIN. Book an Appointment
