Foot Health Is Essential To Overall Health

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How long have you been experiencing foot fungus symptoms?

Please state the length of time in years, months, and or days. *

Have you tried any over-the-counter or prescription drugs?

If any, please provide details below. *

Do you have any pain, itching, or burning in the affected area?

Do you have any pain, itching, or burning in the affected area? *

Are there any visible changes (e.g., discoloration, cracking, peeling)?

Are there any visible changes (e.g., discoloration, cracking, peeling)? *

Do you have a history of similar conditions?

Do you have a history of similar conditions? *

Do you frequently engage in activities that involve damp or moist environments (e.g., swimming, gym)?

Do you frequently engage in activities that involve damp or moist environments (e.g., swimming, gym)? *

Are you diabetic or have any circulation issues?

Are you diabetic or have any circulation issues? *

Are you currently taking any medications that might affect your skin or nails?

Are you currently taking any medications that might affect your skin or nails? *

Have you recently traveled to a tropical or humid climate?

Have you recently traveled to a tropical or humid climate? *

Do you share personal items like shoes or towels with others?

Do you share personal items like shoes or towels with others? *

Do you smoke or consume alcohol?

Do you smoke or consume alcohol? *

Do you have any known allergies to medications or skincare products?

Do you have any known allergies to medications or skincare products? *

Have you experienced any other skin conditions (e.g., eczema, psoriasis)?

Have you experienced any other skin conditions (e.g., eczema, psoriasis)? *

Do you have a weakened immune system or take immunosuppressive medications?

Do you have a weakened immune system or take immunosuppressive medications? *

How frequently do you wash and dry your feet?

How frequently do you wash and dry your feet? *

Have you recently used public showers, locker rooms, or pools?

Have you recently used public showers, locker rooms, or pools? *

Do you experience excessive sweating or dryness in your feet?

Do you experience excessive sweating or dryness in your feet? *

Do you wear socks made from synthetic materials?

Do you wear socks made from synthetic materials? *

Are you currently pregnant or breastfeeding?

Are you currently pregnant or breastfeeding? *

Have you experienced any other symptoms, such as fever or swollen lymph nodes?

Have you experienced any other symptoms, such as fever or swollen lymph nodes? *

Let's start with the basics

This information helps your doctor determine if you’re eligible for treatment.

First Name *

Email *

Phone *

Date of birth *

Postal code *

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