Wareham Surgery

Streche Road, Wareham, BH20 4PG

Current time is 13:56 - Sorry, we're closed

NHS

Telephone: 01929 553444

wareham.surgery@nhs.net

COPD Questionnaire

  • This questionnaire will help you and your healthcare professional measure the impact COPD (Chronic Obstructive Pulmonary Disease) is having on your wellbeing and daily life. Your answers, and test score, can be used by your healthcare professional to help improve the management of your COPD and get the greatest benefit from treatment.

    For each item below, please rate between 0 and 5 which best describes you currently.

  • Date Format: DD slash MM slash YYYY
  • Please enter a number from 0 to 5.
    0 = I never cough, 5 = I cough all the time
  • Please enter a number from 0 to 5.
    0 = I have no phlegm (mucus) In my chest at all, 5 = My chest is completely full of phlegm (mucus)
  • Please enter a number from 0 to 5.
    0 = My chest does not feel tight at all, 5 = My chest feels very tight
  • Please enter a number from 0 to 5.
    0 = When I walk up a hill or one flight of stairs I am not breathless, 5 = When I walk up a hill or one flight of stairs I am very breathless
  • Please enter a number from 0 to 5.
    0 = I am not limited doing any activities at home, 5 = I am very limited doing activities at home
  • Please enter a number from 0 to 5.
    0 = I am confident leaving my home despite my lung condition, 5 = I am not at all confident leaving my home because of my lung condition
  • Please enter a number from 0 to 5.
    0 = I sleep soundly, 5 = I don’t sleep soundly because of my lung condition
  • Please enter a number from 0 to 5.
    0 = I have lots of energy, 5 = I have no energy at all
  • This field is for validation purposes and should be left unchanged.

Opening Times

  • Monday
    08:30 until 13:00
    14:00 until 18:30
  • Tuesday
    08:30 until 13:00
    14:00 until 18:30
  • Wednesday
    08:30 until 13:00
    14:00 until 18:30
  • Thursday
    08:30 until 13:00
    14:00 until 18:30
  • Friday
    08:30 until 13:00
    14:00 until 18:30
  • Saturday
    CLOSED
  • Sunday
    CLOSED