Anasayfa Feedback Form
Feedback Form
Name of practitioner:
Company & Country:
Weight of patient:
Age of patient:
Activity level:
low
mid
high
Serial number of the foot:
1. Walking:
a. Flexibility of toe:
less
sufficent
Excessive
b. Flexibility of heel:
less
sufficent
Excessive
2. Fast walking:
a. Flexibility of toe:
less
sufficent
Excessive
b. Flexibility of heel:
less
sufficent
Excessive
3. Running:
a. Flexibility of toe:
less
sufficent
Excessive
b. Flexibility of heel:
less
sufficent
Excessive
Comments and Suggestions:
HTML Enabled