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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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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232