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  MEET DR. KERCH  CONTACT US  PROVIDERS  Z-COIL  FIND A STORE
 
  MEET DR. KERCH  CONTACT US  PROVIDERS  Z-COIL  FIND A STORE
 
Athlete's Foot Bunions Hammertoes Heel Pain Neuromas Warts Women's Feet

 

Could you be suffering from foot stress?

Take this simple test to see if you might be experiencing foot stress. Answer yes or no.

  1. Do your feet always feel tired at the end of the day?
    Yes       No
  2. Do your feet constantly ache?
    Yes       No
  3. Do you have painful spots on the edges of your feet or toes?
    Yes       No
  4. Do your legs hurt or cramp up?
    Yes       No
  5. Does your lower back hurt?
    Yes       No
  6. Do your ankles swell up?
    Yes       No
  7. Do some of the shoes you wear feel uncomfortable?
    Yes       No
  8. Do you regularly wear high heeled shoes?
    Yes       No
  9. Do you regularly lift objects weighing more than 15 pounds?
    Yes       No
  10. Does your job require safety shoes?
    Yes       No
  11. Do you regularly stand on your feet for periods exceeding 2 hours?
    Yes       No
  12. Do you regularly stand on hard surfaces or in hot environments?
    Yes       No

If you answered yes to any of these questions, you might be experiencing Foot Stress. Early detection of foot stress may prevent long term, painful problems that are often costly to treat. Foot problems don't go away without the right care... they only get worse. Don't wait for the little problem to become a big one. Contact us for help today. Please note that your answers to this self-test are not collected by us.

Foot pain survey

Name:

Address (1):

Address (2):

City:

State:

Zip code:

Phone:

Email:

 

1.

How did you hear about our store and/or Z-CoiL® Footwear? Check all that apply.

 

TV

Friend

NW Women's Show

 

Doctor's referral

Walk-in

Z-CoiL® web site

 

Other:

2.

Are you currently experiencing pain in your feet or ankles? Please rate your pain on a scale of 1 to 10.

 

 

   

   

   

   

   

   

 

3.

If so, have you been told or do you know the reason for your pain?

 

4.

If you were to get them, where would you plan on using your Z-CoiL® footwear? Check all that apply.

 

work

exercise

daily activities

 

Other:

5.

What more would you like to see in our store? Check all that apply.

 

socks

wellness products

arch supports

 

Other:

Thank you for taking the time to fill out our survey. Your answers will enable us to serve you even better in the future.