Live better with COPD
Are you doing everything possible to live your best life? Take the My COPD Checklist today.
Live better with COPD
Are you doing everything possible to live your best life? Take the My COPD Checklist today.
Step 1
The green boxes show us what you told us last time.
If you've made some changes, please pick a new answer where needed.
I have had a breathing test called spirometry to diagnose COPD.
(Required)
Yes
No
Confirming your diagnosis with spirometry.
I have a written COPD Action Plan completed with my GP, nurse or specialist. This helps me manage my COPD and flare-ups (exacerbations).
(Required)
Yes
No
Completing a written COPD Action Plan with your GP, nurse or specialist.
I know what each of my COPD medicines do and when to take them.
(Required)
Yes
No
Knowing what your COPD medicines are for and when to take them.
In the past 12 months, my GP, nurse, specialist or pharmacist have checked how I use my inhalers (the medicines I breathe in).
(Required)
Yes
No
Having your GP, nurse or pharmacist check how you use your inhaler.
In the past 12 months, I have asked my GP or nurse to check I am up to date with vaccinations that protect me from respiratory illnesses.
(Required)
Yes
No
Checking you are up-to-date with vaccinations.
I have done a pulmonary rehabilitation program (classes to help me exercise safely and learn about my COPD).
(Required)
Yes
No
Completing a pulmonary rehabilitation program.
Most days of the week, I am active for 30 minutes, where I breathe harder than normal but am still able to talk.
(Required)
Yes
No
Being active for 30 minutes each day.
If I smoke or vape, I have been offered support to quit.
(Required)
Yes
No
I don’t smoke or vape
Getting support to stop smoking or vaping.
I know it’s important to take care of my mental health and where to get help if I need it.
(Required)
Yes
No
Taking care of your mental health and getting help if you need it.
I see my GP, nurse or specialist at least once a year to review my COPD and how I manage it.
(Required)
Yes
No
Reviewing your COPD and management at least once a year.
Step 2
How are you tracking?
Rate how well you understand COPD and how to manage it.
(Required)
I don't know anything
I know a little
I know some
I know quite a bit
I know a lot
Rate how confident you are to take care of your COPD and make choices about your treatment.
(Required)
Not at all confident
A little confident
Somewhat confident
Quite confident
Very confident
Step 3
Get your updated personalised report
Please confirm your email address below to receive your updated personalised report. You can change the email if you wish to send the report to a different email address.
First Name
(Required)
Last Name
(Required)
Email Address *
(Required)
Unique SF ID
(Required)
Form Identifier
(Required)
Previous submission result
(Required)
