This short questionnaire is meant for new patients, or for people who may be unsure if they need to seek┬átreatment for their difficulty breathing. This is only for your own reference. Only your doctor can diagnose lung disorders and discuss potential reasons for your breathing difficulties. If you answer yes to more than one of these questions, you should speak to your doctor about your symptoms and a spirometry test.
1. ┬áHave you had a long-term cough that is persistent all through the day?
2. ┬áDo you have chronic mucus production when you cough?
3. ┬áHave you had acute bronchitis several times over the last few years?
4. ┬áDo you experience shortness of breath during exercise?
5. ┬áHas your shortness of breath gotten worse when you have been sick?
6. ┬áDo you smoke now, or were you previously a smoker?
7. ┬áDo you have a family history of emphysema or chronic bronchitis?
8. ┬áDo you live or work in the presence of excessive amounts of dust, chemicals, or other airborne irritants?