Psoriatic Arthritis Questionnaire Preferred Location:*Please SelectLa Casita - 326 W. Craig PlaceSonterra - 18707 Hardy Oak BoulevardPatient Name:* First Last Please answer these questions to help your Healthcare Provider determine if you have psoriatic arthritis.1. Do You have a family history of psoriatic arthritis or plaque psoriasis?YesNo2. Have you been diagnosed or treated for plaque psoriasis?YesNoIf so, when were you diagnosed and what treatments did you received? Date diagnosed : Treatments :3. Do you have any of the following symptoms?Joint pain or swelling in your fingers?Changes in your nails (indentations and thickening) ?Joint pain or swelling in your toes or ankles?Back pain or stiffness? Front View : Back View : 4. Do you have joint stiffness that lasts more than 30 to 45 minutes in the morning or after long periods of inactivity? (eg, after sleeping or travelling in a plane or car)YesNo5. Does your psoriatic arthritis affect your day-to-day activities?YesNoIf so, How?e-Signature :*Date This iframe contains the logic required to handle AJAX powered Gravity Forms.