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Carpal Tunnel Self-Assessment
Step 1 of 7: Your details
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Tell us about you
Your name
First name
*
Middle name (optional)
Last name
*
Identity
Date of birth
*
Alberta Personal Health Number (PHN)
Found on your Alberta Health Care card. Leave blank if you don't know it.
Sex
Female
Male
Prefer not to say
Have you previously had surgery to release the carpal tunnel on this hand?
Yes
No
Language & accessibility
Preferred language
*
I would like an interpreter for my appointment.
Acknowledgement
I understand this tool is not a diagnosis, and that my information will be shared with the Carpal Tunnel Efficiency Program's intake team.
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Carpal Tunnel Self-AssessmentCarpal Tunnel Self-Assessment