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Varicose Vein Symptom Quiz

What's your name?

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What is your phone number

Do you have a heavy feeling in your legs at the end of the day?

Do you have a heavy feeling in your legs at the end of the day?
A
B

Do you notice swelling in your ankles or legs, especially in the afternoon or after standing for long periods?

Do you notice swelling in your ankles or legs, especially in the afternoon or after standing for long periods?
A
B

Choose the photo that most closely resembles the visible veins you have

Choose the photo that most closely resembles the visible veins you have
A
B
C
https://storage.tally.so/cd1b0eaa-0c45-47de-bd4b-c0954cf4ff96/veronicapita_form_files_Title-2-.66d73656cfffb5.96078840.png

Do you have visible varicose veins (swollen, twisted veins) in your legs?

Do you have visible varicose veins (swollen, twisted veins) in your legs?
A
B

Do you suffer from night leg cramps?

Do you suffer from night leg cramps?
A
B

Do you have areas of hardened skin or color changes on your lower legs?

Do you have areas of hardened skin or color changes on your lower legs?
A
B

Do you experience itchy legs, especially around swollen veins?

Do you experience itchy legs, especially around swollen veins?
A
B

Do you notice relief in your leg symptoms when you elevate your legs or wear compression stockings?

Do you notice relief in your leg symptoms when you elevate your legs or wear compression stockings?
A
B

Have you had episodes of venous eczema or venous leg ulcers that heal slowly?

Have you had episodes of venous eczema or venous leg ulcers that heal slowly?
A
B

Choose a location for your Vein Treatment