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Self Assessment
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Contact Us
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Vein Health Self Assessment
Leg/Foot Symptoms
Aching/tired legs
Foot/leg pain
Swelling in legs or feet
Tiny spider veins around the ankle, knee or thigh
Itching legs
Nerve or Muscle Symptoms
Burning/stinging/cold feet
Leg cramps or Charlie Horses, especially at night
Numbness/tingling
Restless Legs
Cold feet
General Symptoms
Decreased activity
Poor sleep
Reduced energy
Weight gain
Chronic fatigue/feeling run down
Just A Few More Questions..
Are they worse after standing or sitting?
Yes
No
Are they improved by rest overnight?
Yes
No
Are they worse in the evening / night?
Yes
No
Are they improved with leg elevation (recliner, sofa, etc)?
Yes
No
Are they worse below the knees?
Yes
No
Do you feel run down and tired, especially in evenings?
Yes
No
Submit
Leg/Foot Symptoms
Aching/tired legs
Foot/leg pain
Swelling in legs or feet
Tiny spider veins around the ankle, knee or thigh
Itching legs
Nerve or Muscle Symptoms
Burning/stinging/cold feet
Leg cramps or Charlie Horses, especially at night
Numbness/tingling
Restless Legs
Cold feet
General Symptoms
Decreased activity
Poor sleep
Reduced energy
Weight gain
Chronic fatigue/feeling run down
Just A Few More Questions...
Are they worse after standing or sitting?
Yes
No
Please select Yes or No.
Are they improved by rest overnight?
Yes
No
Please select Yes or No.
Are they worse in the evening / night?
Yes
No
Please select Yes or No.
Are they improved with leg elevation (recliner, sofa, etc.)?
Yes
No
Please select Yes or No.
Are they worse below the knees?
Yes
No
Please select Yes or No.
Do you feel run down and tired, especially in evenings?
Yes
No
Please select Yes or No.
Submit
