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Do you smoke or have you ever smoked?

YesNo

Do you have high blood pressure or are you on blood pressure medication?

YesNo

Do you have high cholesterol or are you on medication to lower your cholesterol?

YesNo

Have you ever been told that you have had a heart attack or stroke?

YesNo

Have you ever had an angioplasty or stent placed in the heart or leg?

YesNo

Have you noticed your walking pace has slowed?

YesNo

Do your legs ever feel tired causing you to stop and rest?

YesNo

When you walk do you ever have to stop because you have pain or cramping in your calves or thighs?

YesNo

Do you ever experience cramping, tightness, "charlie horses" or pain in the legs or feet when lying down that improves when you stand up?

YesNo

Do you have any infections or sores that are not healing on your feet or toes?

YesNo

Is the skin on your legs or feet pale, reddish or purple?

YesNo

Is the skin on your legs or feet cool to the touch?

YesNo

Do you have frequent abdominal or back pain?

YesNo

Do you have a family history of abdominal aortic aneurysm disease?

YesNo