1. Each day on average, do you do 20 minutes of physical activity?

    You can count the time you spend walking, cycling, gardening or anything else that makes you breathe faster.

    Please select one of the options above first
  2. Do you worry about getting out of breath?

    Please select one of the options above first
  3. When do you get out of breath?

    Choose the best description:

    Please select one of the options above first
  4. Do you smoke?

    Please select one of the options above first
  5. What is your height?

    (We only use this to calculate your BMI)

    cm
    ft
    in
    If you're not sure you can enter a rough estimate. You can switch between metric and imperial measures if that helps.
  6. How much do you weigh?

    (We only use this to calculate your BMI)

    kg
    st
    lb
    If you're not sure you can enter a rough estimate. You can switch between metric and imperial measures if that helps.
  7. How old are you?

    Please select one of the options above first
  8. Have you ever seen a doctor, nurse or other health care professional about feeling out of breath?

    Please select one of the options above first
  9. If your doctor, nurse or other health care professional prescribed treatment or suggested things you can do for your breathlessness, has it helped?

    (for example, breathing techniques, using a fan or opening a window, relaxation techniques, meditation or brain training, yoga)

    Please select one of the options above first
  10. Do you feel you know enough about your breathlessness to control it and manage it?

    Please select one of the options above first
  11. Great, we’re nearly done.

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