Remote podiatry service fOOt Specialist Foot Clinic STEP 2: MORE INFO ABOUT YOU & YOUR NEEDS Name* First Last AgeGenderMaleFemaleHeight (cm)Weight (kg)Which of the following conditions do you suffer from? Overweight Diabetes High Blood Pressure High Cholesterol Heart Troubles / Attack Arthritis / Gout Asthma / Lung / Breathing problems Bleeding / Blood Issues Cancer Stroke Other None List the names of any medications you take.Do you smoke?NoYesHave you had any INJURY ON DUTY that involved your feet and/or legs?NoYesHave you had any OTHER INJURY that involved your feet and/or legs?NoYesHave you ever had any SURGERY to your feet and/or legs?NoYesCURRENT SAFETY BOOTSBrandBova (issued by the mine)Sisi (Bova)I don't knowStylePolice Boots (standard issue from the mine)MunichNeoflexChelseaColumbiaSmelters VelcroReese (Sisi)I don't knowSize3456789101112otherDoes your job have special requirements for boots?NoYesOther than the standard rules of covering your ankles.What is your Job title?BlasterBoiler MakerDriverOperatorWelderWhat are the special boot requirements for your job?I NEED HELP WITH: Just a new letter for boots Troubles with my boots Skin and Toenail issues Wounds / Blisters Pain / Injury Swelling Other No issues right now, just downloading the app for future use.
