1. Do you have any pain, burning sensation or numbness in your legs, feet or toes DURING OR AFTER walking?

2. Do you hang your legs over the edge of your bed to relieve the pain?

3. Do you use a cane or a walker?

4.Do you currently smoke for more than 10 years?

5.Do you have a history of diabetes for more than 10 years?

6.Do you have any leg pain or cramps at rest?

7. Do you wakeup with leg pain or cramps at night?

8. Do you have ankle swelling after standing or at the end of the day?

9. Do your legs feel better if you elevate them?

10. Is your skin darker/pigmented around the ankle and foot area?

11. Have you ever had varicose veins? (Excluding spider veins)

12. Have you ever had blood clots in your legs?

13. Do you have any numbness, tingling, or weakness in the legs?

14. Do you have burning or aching pain in the feet or toes while resting?

15. Do you have any sores on your toes, feet or legs that won't heal or heal slowly?

16. Has your family or friends ever mentioned that you walk slowly or rest often during walking?

17. Do your legs feel heavy or tired at the END of the day?