1. Do you have numb, burning, tingling or painful feet/toes?
2. Are your symptoms worse at night, watching TV or during bedtime?
3. Do your feet/legs hurt when you walk, and feel better when resting?
4. Is the skin on your feet/legs dry and flaky?
5. Do you have redness or dark spots on your legs/feet?
6. Are your toenails discolored or brittle?
7. Are your hands and/or feet cold a lot of the time?
8. Do you have pain, burning, tingling or numb fingers/hands?
9. Do you have problems with your balance?
10. Do you have to use your hands to pull/push yourself up when sitting in a chair?
11. Do you struggle putting your shoes on because you can’t reach your feet easily?
12. Is your sleep being affected because of your symptoms?
13. Have you noticed that your symptoms are getting worse?
14. Does it feel like your doctors keep ignoring your symptoms?
15. Are you using a cane or walker to help get around?