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Appendix 5 Adult Questionnaire (ATS-DLD-78-A) Children's Questionnaire (ATS-DLD-78-C) ATS-DLD-78-A Adult Questionnaire NAME: (Last) (Street or Route No.) (First) (Middle Initial) ADDRESS: (City) (County).

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Ask the patient specific questions about shortness of breath that impacts daily living, such as being able to carry groceries from a car, or being able to clean floors or do laundry. Do you have any problems breathing at night? If so, do you use pillows to help you get in a position to breathe easier?

The Respiratory Symptoms Questionnaire (RSQ) is a novel, four-item patient-reported diagnosis-agnostic tool designed to assess the frequency of respiratory symptoms and their impact on activity, without specifying a particular diagnosis.

The Chronic Respiratory Disease Questionnaire (CRQ) is the most commonly used disease specific measurement tool to assess HRQL in patients with chronic respiratory disease. The developers suggest that this tool be used to evaluate the effects of treatment in clinical trials as well as in clinical practice.

The St George's Respiratory Questionnaire is a standardized self-completed questionnaire for measuring impaired health and perceived well-being ('quality of life') in airways disease.

The ATSQ is an 8-item questionnaire measuring morning cough, daily cough, wheezing, shortness of breath when walking, shortness of breath during exercise, phlegm production, chest pain, and fatigue onset.

Respiratory diseases include asthma, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, pneumonia, and lung cancer.

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