Vein Self Evaluation

We invite you to take this quick, free online self evaluation to see if vein treatment is right for you.

Personal Information:

Symptoms and Visual Appearance:


Do you have visibly enlarged bulging veins? (select yes or no)







Do you have areas of small, visible veins which are red, blue, or purple in color? (select yes or no)



Additional Information:


Does anyone in your family have a history of venous disease (varicose veins, spider veins or swollen legs)?






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