Do you have any numbness? | ☐ Yes ☐ No |
Do you have any tingling sensation? | ☐ Yes ☐ No |
Do you have any abnormal sensations? | ☐ Yes ☐ No |
Do you have any pain? | ☐ Yes ☐ No |
Do you have any weakness? | ☐ Yes ☐ No |
Persistence of symptoms after 6 wks. | ☐ Yes ☐ No |
Neurology referral done | ☐ Yes ☐ No |
If yes, findings?
|