Screen Reader Mode Icon

Question Title

* 1. Do you experience aching, cramping or pain  indoor arms, legs, thighs or buttocks when you walk or exercise?

Question Title

* 2. If you answered "yes "to question number one, does the pain subside with rest?

Question Title

* 3. Do you have numbness and tingling in the arms or lower legs and feet?

Question Title

* 4. Are your fingers or toes pale, discolored, and bluish?

Question Title

* 5. Are your hands or feet cold to the touch?

Question Title

* 6. Do you have any sores or ulcers on your legs or feet that don't heal?

Question Title

* 7. Do you have difficult to control blood pressure on more than two blood pressure medications?

Question Title

* 8. Do you exercise on a regular basis?

Question Title

* 9. If not, what keeps you from exercising?

Question Title

* 10. Do you have a family history of aortic aneurysm?

Question Title

* 11. Have you ever experienced a stroke, mini-stroke or transient ischemic attack (TIA)?

Question Title

* 12. First Name

Question Title

* 13. Last Name

Question Title

* 14. Date of Birth

Date

Question Title

* 15. Gender

Question Title

* 16. Phone

Question Title

* 17. Email Address

( Privacy & Cookie Notice
0 of 17 answered