COPD review | Talbot Green Doctors

Based on your current situation, please rate the severity of your cough on a scale of 0-5

Based on your current situation, please rate the severity of your phlegm (mucus) on a scale of 0-5

Based on your current situation, please rate the severity of your chest tightness on a scale of 0-5

Based on your current situation, please rate the severity of your breathlessness on a scale of 0-5

Please rate how limited to doing activites at home you are on a scale of 0-5

Please rate how confident you are leaving your home despite your lung condition on a scale of 0-5

Based on your current situation, please rate how soundly you sleep on a scale of 0-5

Which one of these best describes your breathing?

Would you like to be referrred for pulmonary rehab?

Have you been admitted to hospital for urgent treatment of your COPD in the last 12 months?

Have you had any exacerbations (flare-ups) of your COPD in the last 12 months?

Do you have oxygen at home (either long-term oxygen therapy or oxygen using a mask)?

Do you have a nebuliser at home?

Do you have steroid and antibiotic tablets at home in case your condition worsens suddenly?

An annual flu jab is recommended for yourself

Do you smoke?

Would you like help to stop smoking?

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