May 25, 2013

Self Assessment Test

Do you have venous reflux disease? Take a few minutes to answer these questions; if you answered “yes” to any of the history and symptoms questions, please print and take to your physician. Your doctor may want to schedule an ultrasound test to diagnose venous reflux disease.

  • Please [click here] for online Self Assessment Test Form. Complete and print from computer.
  • Please [click here] for PDF Self Assessment Test Form.