615-269-9007
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Vein Quiz

Are you concerned about the appearance of your legs?*
- Yes
- No
Do you have enlarged veins on your legs?*
- Yes
- No
Do the veins cause bumps that can be felt under the skin?*
- Yes
- No
Do you experience aching of the legs after standing or walking for a long time that interferes with your daily life?*
- Yes
- No
Do you experience swelling of the lower legs?*
- Yes
- No
Please check all boxes that apply
- Is there a history of vein problems in your bloodrelated family?
- Are you fatigued, tired, or have heavy-feeling legs?
- Do you have visible varicose and/or spider veins?
- Do you have leg pain caused by prolonged standing or sitting?
- Is there itching, tingling, numbness, cramping or burning in your legs or feet?
- Do you have swollen ankles at the end of the day?
- Do you have discoloration of the skin in your lower legs?
- Do you have open sores or ulcers of the lower legs and ankles
You might have vein disease
FILL OUT OUR eVEIN SCREENING FORM
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FRANKLIN

125 Cool Springs Blvd, Suite 250
Franklin, TN 37067
Phone: 615-503-9895
Fax: 615-778-3249

NASHVILLE

4535 Harding Pike, Suite 304
Nashville, TN 37205
Phone: 615-269-9007
Fax: 615-269-3448

MOUNT JULIET

660 South Mount Juliet Rd, Suite 211
Mount Juliet, TN 37122
Phone: 615-932-8346
Fax: 615-891-5048

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About
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