Please take this self-assessment to see if you might be a candidate for additional screening for potential varicose veins and / or chronic venous insufficiency. Questions Page Have you ever had varicose veins? Yes No This field is required Do you experience leg pain, aching or cramping? Yes No This field is required Do you experience leg or ankle swelling, especially at the end of the day? Yes No This field is required Do you feel “heaviness” in your legs? Yes No This field is required Do you experience restless legs? Yes No This field is required Do you have skin discoloration or texture changes? Yes No This field is required Do you have open wounds or sores? Yes No This field is required Has anyone in your blood-related family ever had varicose veins or been diagnosed with venous reflux disease or chronic venous insufficiency? Yes No This field is required Have you had any treatments or procedures for vein problems? Yes No This field is required Do you stand for long periods of time, such as at work? Yes No This field is required Do you get pain or discomfort in your legs when you walk? Yes No This field is required Does this pain disappear when you rest for less than 10 minutes? Yes No This field is required Nice try spambot Next