Question 1/10

Have you been diagnosed with COPD, emphysema, or chronic bronchitis?

Yes
No

Question 2/10

Do you experience difficulty breathing or shortness of breath?

Always
Often
Occasionally
Never

Question 3/10

How often do you have a persistent cough?

Daily
Weekly
Rarely
Never

Question 4/10

Do you currently or have you previously smoked cigarettes?

Yes
No

Question 5/10

Do you use a rescue inhaler or nebulizer?

Yes
No

Question 6/10

How often do you experience fatigue or low energy levels?

Always
Often
Occasionally
Never

Question 7/10

Have you had a lung function test in the past year?

Yes
No

Question 8/10

Do you take long-term medications for COPD?

Yes
No

Question 9/10

Do you avoid activities due to breathing difficulties?

Yes
No

Question 10/10

Would you be interested in educational resources for COPD management?

Yes
No