Peripheral Artery Disease
Restless Legs Syndrome
Vascular Risk Assessment
Fillers & Injectables
Virtual Vein Screening
Patient Provides contact information
Patient Assesment Question
Do you experience any of the following signs and symptoms in your legs or ankles
Leg pain itching and cramping
Burning and itching of the skin
Havey Felling in legs
Leg or ankels swelling ,espically at the end of the day
Visible varicose or spider venis
Skin discolration or texture changes ,such as above the inner ankle
Open wounds or sores ,such as above the inner ankles restless leg syndroms
Patient Risk Factors
Has anyone in your blood-related family had varicose veins or been diagnosed with chronic venous insufficiency or venous reflux?
Have you had any treatments or procedures for vein problems?
Do you stand for long periods of time, such as at work?
Do you frequently engage in heavy lifting?
Have you ever been pregnant?
Patients sends Photos To your office via VSA’s HIPPA Compliant Server
2633 Superior Drive NW Suite 100 Rochester MN 55901
1515 St. Francis Ave, STE 250, Shakopee MN, 55379
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