204 West Jackson Street | Suite A Ridgeland, MS 39157

Risk Assessment

Do I Have a Venous Disease?

Use the test below to determine whether or not you may have venous disease. Use the following scale to choose the most appropriate number for each situation.

0 = Never | 1 = Occasionally | 2 = Frequently

1. Do you experience swelling in your legs, ankles or feet?

2. Do you experience pain in your legs?

3. Do you have varicose veins?

4. Do you experience cramping in your legs or calves?

5. Do you experience restless legs at night?

6. Do you experience itching or skin changes on your legs?

7. Do you work in a profession where you are on your feet a large part of the day?

Your Total:
0

Anyone with a 2 or higher should call to schedule an appointment for a full evaluation.


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