{"text":"GLASGOW FOOT AND ANKLE OUTCO.MES \nQUESTIONNAIRE \nL \n. F \n*ZLE';:AND 08\/08195! \ngn \n39 Rennle Road \nKilsyth \n. T . \nGlasgow. Lanarkshire 65 9P \n= \neren s oume e OV \nDear Patient, \nWelcome to the Glasgow Ortiwpaedic Foot and Ankle Unit \nWe would like you to complete this questionnaire regardmg your gen eral health and \nyour specific foot \/ ankle problem. This should take no longer than 1 \n0 minutes. \nThis questionnaire is important. Your results will help us to find out vr\/hat the \nbenefits of different treatments are as well as allowing us to comparg our results \nwith those of other surgeons to ensure we are providing the best service that we \ncan. -\u2019 \nYou will be asked to fill out thls questnonnalre on more that one occasion so that we \ncan measure your progress \nAll the information gathered i in this surv\u00e9y will be treated in strict co \nPlease try to answer every question. \nPlease provide \nnfidence. \nContact Landline Phone Numb;ar (\u2019) { Q % % \n7712\/ \nContact Mobile Number . O ?75'5 55 ga \nEmail\u2018address ] | \nConsent to participation (Fu.rther information regarding the Dat \n1998 on last page) : . C \nI consent to my personal details being recorded. \nSignature 4 - \u2019 Date \na Protection Act. | \n\/%A\/L\u201cL | | l\u2019_\/'_'l\ufb01f\u201c\/% \nPlease tum to next page \nPage 1 of 6 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