A patient assessment should be completed before the evaluation is performed. This includes assessment of the patient's ability to tolerate the procedure and evaluation of any contraindications to the procedure. The sonographer or examiner should obtain a complete, pertinent history by interview of the patient or patient's representative and review of the patient's medical record, if available. A pertinent history includes:

• Risk factors for lower extremity venous insufficiency, previous deep vein and/or superficial vein thrombosis (DVT/SVT)
• Current medications or therapies
• Family history of venous thrombosis
• Lower extremity trauma
• History of venous ulcers and/or varicosities
• History of previous vein surgeries or interventions
• Venous ablation procedures
• Venous stripping
• Vein harvest
• Iliac vein stenting for iliac vein compression (May-Thurner Syndrome)
• Sclerotherapy
• Congestive heart failure (CHF) or other similar cardiac history
• Current medications and/or therapies
• Results of other relevant diagnostic procedures

Complete a limited physical exam which includes observation and localization of the presence of any signs or symptoms of peripheral venous disease, including:

• Swelling
• Pain/tenderness
• Palpable cord
• Discoloration
• Varicosities
• Ulceration
• Verify that the requested procedure correlates with the patient’s clinical presentation
• Patterns of veins along the medial, lateral and posterior lower extremity (helps to identify source of varicose veins, spider veins, accessory saphenous veins and/or perforators).