PROSTHETIC CENTER SELF ASSESSMENT

Have you ever had an amputation?*

Has your doctor recommended amputation surgery?*

Are you currently scheduled to undergo amputation?*

Do you experience any of the following issues with your prosthesis?*

Is your current prosthesis easy to put on and take off?*

Is your current prosthesis wearable all day without causing irritation or discomfort?*

Do you feel you have full control of the prosthesis?*

Have you recently started or would you like to start any new hobbies such as golf or running?*

Email

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