Full Name
*
Email
*
Phone
*
How Long Have Your Suffered Or Worried?
*
Haven't - this is prevention not cure
1-2 weeks
2-4 weeks
1-3 months
Long enough
Seems like too long (years)
What does it stop you from doing?
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What concerns you most about your foot and ankle pain?
*
What concerns you most about your foot and ankle pain?
Not knowing what's wrong
You want to avoid depending upon painkillers to ease pain
Losing mobility or independence due to chronic pain
The risk of facing dangerous surgery due to chronic pain
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