PAD Assessment

1. Do you have pain or cramping in the legs when walking and/or laying flat?

2. Do have any of the following : diabetes, high blood pressure, high cholesterol, over age 50.

3. Are you currently using or have you used products with nicotine?

4. Do you have any history of coronary artery disease, strokes, or a known history of peripheral artery disease?

5. Do you have any changes in the color or sores on your legs, feet or toes?

Thank you for completing the assessment.

Please provide us with your contact information, so we can give you a call back.
Your privacy is very important to us. We will not share your information outside of our practice.