Questionnaire #2
Leave questions blank if you are not sure of the answer.
In the following questions, "arch support" includes Birkenstock sandals and inserts that have good arch support. "Night splints" include the Strassburg Sock.
Which treatments helped the most?
acupuncture+
surgery+
cast+
night splint+
ultrasound+
ice+
massage+
tape+
pills+
heel pads+
rest+
injections+
arch support+
stretching+
lost weight+
heat+
chiropractor+
acupuncture+
surgery+
cast+
night splint+
ultrasound+
ice+
massage+
tape+
pills+
heel pads+
rest+
injections+
arch support+
stretching+
lost weight+
heat+
chiropractor+
acupuncture+
surgery+
cast+
night splint+
ultrasound+
ice+
massage+
tape+
pills+
heel pads+
rest+
injections+
arch support+
stretching+
lost weight+
heat+
chiropractor+
Which treatments helped the least?
acupuncture-
surgery-
cast-
night splint-
ultrasound-
ice-
massage-
tape-
pills-
heel pads-
rest-
injections-
arch support-
stretching-
lost weight-
heat-
chiropractor-
acupuncture-
surgery-
cast-
night splint-
ultrasound-
ice-
massage-
tape-
pills-
heel pads-
rest-
injections-
arch support-
stretching-
lost weight-
heat-
chiropractor-
Enter a number for the following:
I have had it for
months. I weigh
pounds. My height is
feet
inches.
The treatment I have received from my doctor has been:
good
fair
bad
Answer the following if you have had an injection: Have you stopped seeing a doctor to avoid further injections?
yes.
no.
sort of.
Enter the name of any product that has helped a great deal: