Dr Lunz - Foot & Ankle Survey FormInstructions: This survey asks for your views about your health. This information will help us keep track of how your symptoms interfere with your functioning.
Please answer every question by filling in the appropriate circle, only one selection for each question. If you are unsure about how to answer a question, please give the best answer you can.
Alternatively, you may download this printable version to bring with you on the day. SOSFAI Foot & Ankle Survey - PDF