| Varicose veins• • • | Location Comments | 
| Quality• • • | Quality Comments | 
| Severity | Severity Comments | 
| Duration• • • | Chronic | 
| Onset / Timing• • • | Onset Comments | 
| Context• • • | Context Comments | 
| Modifying Factors• • • | Modifying Factors Comments | 
| Associated Symptoms• • • | Associated Symptoms Comments  | 
| Previous Treatment |  | 

