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Insurance Questionnaire

Most insurances cover vein treatments if all of the following therapies have been tried. Have you tried the following?

Prescription compression stocking use
Increased physical activities such as exercise or walking
Leg elevation
Over-the-counter pain medicines

Most insurances cover vein treatments if you still experience symptoms despite trying other therapies. What symptoms are you currently experiencing?

Tired, achy, throbbing, painful legs
Leg cramps or restless legs
Foot pain, tingling, numbness or burning
Leg swelling or heaviness
Itching, bleeding, or skin sores
Low energy or poor sleep

Most insurances cover vein treatments if your leg symptoms are causing limitations with activities. Which of these activities do you experience limitations with currently?

Sitting, standing, or riding for long periods
Shopping, housekeeping, home duties
Taking care of yourself, children, or family
Exercise, walking or maintaining an active lifestyle
Job performance duties
Trouble sleeping
Needing to rest and elevate legs in a recliner or sofa due to discomfort
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877-870-5244
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