Office Visit Prep Tool

1. How often do you experience the following symptoms?



Chest tightness

Shortness of breath

Bringing up mucus

2. Over the past 3 months, your symptoms have:

3. Do you use a rescue inhaler? (for sudden symptoms)

4. Do you feel that you're using your rescue inhaler device correctly?

5. Do you take a maintenance medication to relieve your COPD symptoms?
Maintenance means COPD medicines your doctor prescribed for long-term use, usually once or twice daily.

6. Are you aware of the different maintenance therapy and device options for COPD that may be appropriate for your condition?