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Welcome to the COPD Assessment Test™

This questionnaire will help you and your healthcare professional measure the impact COPD (Chronic Obstructive Pulmonary Disease) is having on your wellbeing and daily life.

Your answers, and test score, can be used by you and your healthcare professional to help improve the management of your COPD and get the greatest benefit from treatment.

Please answer the following 8 questions and be sure to only select one response for each question.

1) Please select how much you agree with the following statement.

How often do you cough?

e.g. 0 = I never cough 5 = I cough all the time

 

 
2) Please select how much you agree with the following statement.

How much phlegm (mucus) is in your chest?

e.g. 0 = I have no phlegm in my chest at all, 5 =My chest is completely full of phlegm (mucus)

 

 
3) Please select how much you agree with the following statement.

How does your chest feel?

e.g. 0 = My chest does not feel tight at all, 5 = My chest feels very tight

 

 
4) Please select how much you agree with the following statement.

How breathless do you get during activity? 

e.g 0 = When I walk up a hill or one flight of stairs I am not breathless, 5 = When I walk up a hill or one flight of stairs I am very breathless

 

 
5) Please select how much you agree with the following statement.

How limited are you doing activities around your home? 

e.g. 0 = I am not limited doing any activities at home, 5 =  I am very limited doing activities at home

 

 
6) Please select how much you agree with the following statement.

How confident are you leaving your home with your lung condition? 

e.g. 0 = I am confident leaving my home, 5 =  I am not at all confident leaving my home because of my lung condition

 

 
7) Please select how much you agree with the following statement.

How does your lung condition affect your sleep?

e.g. 0 = I sleep soundly, 5 = I don’t sleep soundly because of my lung condition
8) Please select how much you agree with the following statement.

How much energy do you have?

0 = I have lots of energy, 5 = I have no energy at all

 

 

Be sure to click Submit Quiz to see your results!



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