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1. Default Section

Any Questions with an asterisk * requires at least one answer in order to complete the survey.

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* 1. Please Provide

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* 2. Do You Have A Preference in Ski Shops?

 
Alpine Pro
Can Ski Blackcomb
SureFoot Whistler

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* 3. Please Choose Your Preferred Time To Do Your Screening

  Month Day
Date & Time

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* 4. What is Your Running Shoe Size and Your Ski Boot Size?

  Shoe Size Ski Boot Size [Mondo]
Shoe + Boot Size

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* 5. Tell Us About Your Ski Boots?

  Condition
Boot Shell
Boot Liner
Footbed

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* 6. Where Did You Purchase Your Ski Boots?

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* 7. What Level of Skier Are You?

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* 8. Are you currently wearing knee braces or other support devices?

 
Left Knee Brace/Support
Right Knee Brace/Support
Mojo's

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* 9. Have you had a hip or knee replacement?

 
Left Hip
Right Hip
Left Knee
Right Knee

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* 10. Have You Ever Had Your Alignment Corrected?

  Knock Kneed Bow Legged Fore/Aft
Yes Left Boot Side
Yes Right Boot Side
No

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* 11. What Is Your Motivation To Take The Screening?

  1st Choice 2nd Choice 3rd Choice
I Have Recently Purchased New Equipment But Recognize That Something is Still Wrong
My Equipment is showing it's age and I want to replace it and get it done right
I suspect that there is something structurally misaligned in my legs/feet and want it corrected

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* 12. How Did You Hear About The Structural Alignment Screen?

T