Survey Text

1990
top
1990
Survey form view entire document:  text  image
I. Arthritis of the toes?
1[] Yes
2[] No

Complete questions 2 and 3 separately for up to 4 foot problems for each person.

[option to enter up to 4 foot problem in the original document not presented here. The questions and answers are the same for all 4 foot problems]

First Foot Problem in Question 1:

Letter in 1 ____
Problem ____

2. Does -- still have (problem) or has it gone away or been cured?

1[] Still has problem
2[] Gone away/cured