Instructions:
Below you will see a grid showing views of various angles of a foot. Please indicate by grid references where your pain resides. For example pain in your heal will be one or more of the following grid references: D11, D12, C16, D16, D21, D22, C5, C6.
You must enter at least 1 grid reference. You can add up to 4 grid references to better define the location of your pain.
Please select the grid references that best identify the location of your pain most accurately.