Please take this self-assessment to see if you might be a candidate for additional screening for potential varicose veins and / or chronic venous insufficiency.
|Have you ever had varicose veins?||O Yes||O No|
Signs and Symptoms
Do you experience any of the following signs and symptoms in your legs or ankles?
|Do you experience leg pain, aching or cramping?||O Yes||O No|
|Do you experience leg or ankle swelling, especially at the end of the day?||O Yes||vO No|
|Do you feel “heaviness” in your legs?||O Yes||O No|
|Do you experience restless legs?||O Yes||O No|
|Do you have skin discoloration or texture changes?||O Yes||O No|
|Do you have open wounds or sores?||O Yes||O No|
|Has anyone in your blood-related family ever had varicose veins or been diagnosed with venous reflux disease or chronic venous insufficiency?||O Yes||O No|
|Have you had any treatments or procedures for vein problems?||O Yes||O No|
|Do you stand for long periods of time, such as at work?||O Yes||O No|
If you answered yes to one or more of the above questions, please contact us for a consultation to see if you may be developing venous reflux disease.