If you have been advised by the surgery to submit a COPD assessment please use this form.
This assessment will help us measure the impact of COPD (Chronic Obstructive Pulmonary Disease) is having on your wellbeing and daily life. Your score will be used by us to help improve the management of your COPD and get the greatest benefit from treatment.
For each of the questions on this form, please choose the answer by selecting the number that best describes you currently. Only one response per question can be selected.