479.777.8014 Schedule My Consultation Virtual Vein Screening Tool

479.777.8014 Schedule My Consultation Virtual Vein Screening Tool

479.777.8014 Schedule My Consultation Virtual Vein Screening Tool

Vein Treatments Near Me

Name: Ozark Regional Vein Center
Address: 5433 W. Walsh Lane, Suite A, Rogers, Arkansas, 72758, United States
Telephone: 4797778014

Vein Screening Tool

First Name*
Phone Number*
Email Address*
Do you have visible varicose or spider veins?
- Yes
- No
Have you received any prior vein treatments?
- Yes
- No
Is there a history of vein problems in your blood related family.
- Yes
- No
- I'm not sure
Is there a history of blood clots in your blood related family?
- Yes
- No
- I'm not sure
Do you have any of the following signs or symptoms?
- Leg fatigue
- Open sores or ulcers on the lower legs/ankles
- Itching on the legs/feet
- Tingling in the legs/feet
- Leg heaviness
- Skin discoloration in the lower legs
- Swelling of the ankles
- Tiredness in the legs
- Leg pain (caused by prolonged standing or sitting)
(Select all that apply)
Are there any other aesthetic concerns you would like us to address in your consultation? (Select all that apply)
- Wrinkles
- Aging
- Acne
- Excess fat
- No
- I'm not sure
When would it be convenient for you to visit us for your consultation?
- Morning
- Afternoon
- It doesn't matter
Upload a photo of your areas of concern. (Optional)
No file selectedBrowse

Stay up-to-date with all the latest news at Ozark Regional Vein Center.