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Evaluation

Are you evaluating a patient with diabetes mellitus?

Does the patient have a history of diabetic foot ulceration or amputation?

Does the patient have any problem seeing the feet?

Is the patient physically able to reach and manipulate both feet?

Does the patient have a deformity or callus of the left foot?

Does the patient have a deformity or callus of the right foot?

Number of palpable pulses in the left foot (enter 0, 1 or 2)

Number of palpable pulses in the right foot (enter 0, 1 or 2)

Number of sites where the 10 gram monofilament can be felt on the left foot (enter from 0 to 5)

Number of sites where the 10 gram monofilament can be felt on the right foot (enter from 0 to 5)

Results

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