Survey Form
Name
Contact Number
Email Address
City
1. How often you examine the patients who had past history of foot infection?

Once in a year
Once in 6 Months
Once in three Months
Others (Please Specify)
2.What are methods used to diagnose High Risk Foot?

128 HZ tuning fork
Monofilament test
Biothesiometer
Others (Please Specify)
3.What are foot care problems you treat?

Callus Debridement
In growing toe nail
Cellulites
Charcot foot
Gangrene
Wound Debridement
Toe amputation
Tendon Achilles lengthening
Below knee amputation
Others (Please Specify)
4.Do you do any procedures? If Yes Please Specify?

Yes
No
5.Whom do you refer the patients having foot infection?

General surgeon
Othropedic surgeon
Podiatric surgeon
Plastic Surgeon
Treated by self
Others (Please Specify)
6. When do you refer your patient to Vascular Surgeon ?

History of claudication
ABI > 0.8
Both of the above
None of the above
7. What sort of offloading you advice for patients with foot ulcer?

TCC
Any other material (Please Specify)
8. Whom do you refer for offloading?

Qualified Orthotist & Prosthethist
Shoe maker
Self
Others (Please Specify)
9. Do you use antibiotic in a OP Setting?

Yes
No
10. Do you use any growth factor for wound healing?

Yes
No
11. Do you use negative pressure wound therapy for wound healing?

Yes
No
12. Are you interested in taking part in our other studies conducted by DFRI?

Yes
No