Online Scheduling for TOI’s Express Ortho Urgent Care Clinics Now Available! Book an Appointment

Services
Physicians
Resources
About
Locations
- Contact Us
Request an Appointment
(352) 336-6000

Foot and Ankle Assessment

"*" indicates required fields

Step 1 of 2

50%

Tell us about your pain, and we’ll tell you where you stand and what you might consider doing next.

When foot or ankle pain makes daily tasks harder or keeps you from the activities you enjoy, it’s time to get expert help—without needing a referral. This ten-question assessment takes about 5 minutes, and we’ll email you the results.

Did your pain happen after a sudden event or injury, or has it been bothering you for a while?*

I was recently injured

It's been bothering me for a while now

Can you bear weight on the affected foot or ankle?*

Yes, with no problems

Yes, with mild annoyance

Some trouble

Extreme difficulty

Impossible to do

Does your foot or ankle ever give way, or feel unstable?*

Never

Not often (once a week)

Sometimes (more than once a week)

Often (almost daily)

Constant (daily)

Do you have pain when walking on your foot or ankle?*

Never

Not often (once a week)

Sometimes (more than once a week)

Often (almost daily)

Constant (daily)

How painful is it?*

Mild

Moderate

Severe

How often does this foot or ankle problem prevent you from working or exercising?*

Never

Not often (once a week)

Sometimes (more than once a week)

Often (almost daily)

Constant (daily)

Is there any swelling or bruising on your foot or ankle?*

Yes

Is there a visible deformity on your foot or ankle?*

Yes

Do you suspect this is related to a previous surgery on your foot or ankle?*

Yes

Have you been told by a medical provider that this problem is worth seeking further treatment for?*

Yes

Submit your answers, and we'll email you the results. We'll also follow up with next steps and contact information to help you get closer to returning to the activities you love.

Disclaimer

OrthoNebraska pain assessments are not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. For a full diagnosis, schedule an appointment with one of our specialists, visit an OrthoNebraska Orthopedic Urgent Care or our emergency room. You understand that by completing this form, you are consenting to receive phone and email communications from OrthoNebraska, but you can opt-out at any time.

Have you ever been a patient at OrthoNebraska?*

Yes

What is Your Gender?*

Male

Female

Non-Binary or Other

Name*

First Name Last Name

Phone*

Email*