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Risk Assessment Survey

Risk Assessment Survey

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 | 3 = Daily

  • Your Total:
  • Anyone with a 4 or higher should call to schedule an appointment for a full evaluation.