BLF Breath Test

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.

Yes No
Please select one of the options above first
Do you worry about getting out of breath?

Yes No
Please select one of the options above first
When do you get out of breath?

Choose the best description:

I’m not troubled by being out of breath except on strenuous exercise I’m short of breath when hurrying on the level or walking up a slight hill I walk slower than most people on the level, stop after a mile or so, or stop after 15 minutes of walking at my own pace I stop for breath after walking about 100 yards or after a few minutes on level ground I’m too breathless to leave the house, or breathless when dressing and undressing
Please select one of the options above first
Do you smoke?

Yes No
Please select one of the options above first
What is your height?

(We only use this to calculate your BMI)

cm feet and inches

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.
How much do you weigh?

(We only use this to calculate your BMI)

kg stones and pounds

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.
How old are you?

years

Please enter your age
Have you ever seen a doctor, nurse or other health care professional about feeling out of breath?

Yes No
Please select one of the options above first
Do you have a diagnosis of a condition that makes you breathless?

A lung or respiratory condition A heart condition Both Neither
Please select one of the options above first
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)

Yes No
Please select one of the options above first
Do you feel you know enough about your breathlessness to control it and manage it?

Yes No
Please select one of the options above first
Great, we’re nearly done.

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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.

Do you worry about getting out of breath?

When do you get out of breath?

Choose the best description:

Do you smoke?

What is your height?

(We only use this to calculate your BMI)

How much do you weigh?

(We only use this to calculate your BMI)

How old are you?

Have you ever seen a doctor, nurse or other health care professional about feeling out of breath?

Do you have a diagnosis of a condition that makes you breathless?

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)

Do you feel you know enough about your breathlessness to control it and manage it?

Great, we’re nearly done.