schedule teledoc
  • 1 Current Patient Information
  • 2 Patient Assessment Questions
  • 3 Complete

Please fill out the form below in its entirety and upload photos of your legs. All submitted forms will receive a call to schedule a free, 10-minute telemedicine vein screening with one of our vein doctors or physician assistants to discuss your vein concerns.

This offer expires on December 31, 2020. Free vein screening must occur on or before December 31, 2020. This offer is only valid at Fairfax Vein Center. One free consultation per person during the promotional period. Not redeemable for cash.

We will not share, rent, or sell the information you provide.