Step 1 of 7

Are you under or over the age of 50?

Under 50

Over 50

Step 2 of 7

When were you first diagnosed with neuropathy?

Never been diagnosed
Less than 3 months
Between 3 & 12 months
Between 1-5 Years
More than 5 Years ago
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Step 3 of 7

What were you told is the cause of your neuropathy?

Diabetes

Chemotherapy

Toxic Exposure

Genetic/Familial

Autoimmune

Spine Related

Idiopathic/Unknown

Other

Step 4 of 7

What symptoms do you have?

Pain

Burning

Numbness

Tingling

Cramping

Imbalance

No symptoms

Step 5 of 7

What was recommended for your neuropathy?

Gabapentin/Neurontin/Lyrica

Cymbalta

Opioid Pain Pills (Norco, Oxycodone, Percocet, Fentanyl, Morphine)

Cane/Walker/Wheelchair

Nothing was recommended

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