Venous Leg Ulcer Assessment Form 

The Venous Leg Ulcer Assessment Form was developed by the NZWCS Leg Ulcer Working Group (LUWG) and is based on best practice guidelines. The form has been successfully trialled in seven private and public practice areas in New Zealand and will be integrated into the Venous Ulcer Clinical Pathway currently being piloted.

The form is to be used in conjunction with the New Zealand guideline - Care of People with Chronic Leg Ulcers: An evidence based guideline (New Zealand Guidelines Group, 1999).

Download the Venous Leg Ulcer Assessment Form (PDF 210kb)

Members of the LUWG are nurses specialising in venous leg ulcer assessment and management. The group members are:

- Mandy Pagan
- Pip Rutherford
- Cathy Hammond
- Jenny Phillips
- Julie Betts
- Kate Gray
- Elizabeth Frost
- Margaret Mossop
- Rowena McGrath
- Susan McAuley

Disclaimer: The NZWCS does not take any responsibility for any outcomes achieved through using this form. The form is for competent healthcare professionals (HCPs) trained in leg ulcer assessment and does not replace the HCPs clinical judgement in each individual case.