The revised Leg Ulcer Assessment Form (2015) should be used in conjunction with the Australian and NZ Clinical Practice Guideline for Prevention and Management of Venous Leg Ulcers.

The form is for competent healthcare professionals trained in leg ulcer assessment to aid leg ulcer diagnosis through history, examination and investigations.

Download the Leg Ulcer Assessment form (PDF)

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