Step 1 of 9 11% Providing Hope for Severe COPD/Emphysema Patients Share Your Experience with Us Are you or a loved one living with severe COPD/emphysema? Your unique perspective can inspire and help others. Take a moment to answer a few brief questions about your journey.Gender(Required) Male Female Prefer not to say Age(Required) 30 or under 31-40 41-50 51-60 61-70 71 or older EUR-EN-1421-v3 Please choose your country from the dropdown menu.(Required)EnglandNorthern IrelandScotlandWalesOtherPlease choose your county in England from the dropdown menu.(Required)Choose a CountyBedfordshireBerkshireBristolBuckinghamshireCambridgeshireCheshireCornwallCumbriaDerbyshireDevonDorsetDurhamEast Riding of YorkshireEast SussexEssexGloucestershireGreater ManchesterHampshireHerefordshireHertfordshireIsle of ManIsle of WightKentLancashireLeicestershireLincolnshireLondonMerseysideMiddlesexNorfolkNorth YorkshireNorthamptonshireNorthumberlandNottinghamshireOxfordshireRutlandShropshireSomersetSouth YorkshirStaffordshireSuffolkSurreyTyne and WearWarwickshireWest MidlandsWest SussexWest YorkshireWiltshireWorcestershirePlease choose your county in Northern Ireland from the dropdown menu.(Required)Choose a CountyCounty AntrimCounty ArmaghCounty DownCounty FermanaghCounty LondonderryCounty TyronePlease choose your county in Scotland from the dropdown menu.(Required)Choose a CountyAberdeenAberdeenshireAngusArgyll and ButeClackmannanshireDumfries and GallowayDundeeEast AyrshireEast DunbartonshireEast LothianEast RenfrewshireEdinburghFalkirkFifeGlasgowHighlandInverclydeMidlothianMorayNorth AyrshireNorth LanarkshireOrkneyPerth and KinrossRenfrewshireScottish BordersShetland IslesSouth AyrshireSouth LanarkshireStirlingshireWest DunbartonshireWest LothianWestern IslesPlease choose your county in Wales from the dropdown menu.(Required)Choose a CountyAnglesey/Sir FonBlaenau GwentBridgendCaerphillyCardiffCarmarthenshireCeredigionConwyDenbighshireFlintshireGlamorganGwyneddMerthyr TydfilMonmouthshireNeath Port TalbotNewportNewport CityPembrokeshirePowysRhondda Cynon TaffSwanseaTorfaenWrexhamWhere do you live? Which, if any, of these conditions have you been diagnosed with? (select all that apply)(Required) COPD Emphysema I don't know If you have been diagnosed with COPD, do you know which GOLD stage you are currently in?(Required) Stage 1 (mild) Stage 2 (moderate) Stage 3 (severe) Stage 4 (very severe) No, I don't know Please rate the level of your breathlessness:(Required) I only get breathless with strenuous exercise I get short of breath when hurrying on level ground or walking up a slight hill On level ground, I walk slower than people of my age because of breathlessness I stop for breath after walking about 100 yards or after a few minutes on level ground I am too breathless to leave the house or I am breathless when dressing/undressing Which of these treatments, if any, are you currently using to treat your condition? (select all that apply)(Required) Inhalers Supplemental Oxygen Pulmonary Rehab Other How did you first hear about further treatment options for severe COPD/emphysema with the Zephyr Valve?(Required) Social media (such as Facebook) Google (or internet search) Local media (TV, newspaper, etc.) My primary care physician/community nurse My pulmonologist or chest physician At pulmonary rehab Friends or family Have you talked to your doctor(s) or medical professional(s) about further treatment options like Zephyr Valve? And if so, which one(s)?(Required) Primary Care Physician/Family Doctor Pulmonologist/Chest Physician Someone at a Zephyr Valve Treatment Center No, I have not spoken to a medical professional about this treatment option. If you did speak with your doctor about Zephyr Valves, did they already know about the treatment?(Required) Yes No Have you had any additional testing to determine if you could be a candidate for further treatment options like the Zephyr Valve?(Required) Yes No Did you get further treatment or a procedure scheduled?(Required) Yes, Zephyr Valves/endobronchial valve treatment Yes, lung volume reduction surgery Yes, lung transplant No, I was not eligible for further treatment options What topic(s) are of highest interest to you concerning the disease?Your Insights Matter Your input is crucial in enhancing the support and care to individuals dealing with COPD/emphysema. Your feedback will remain confidential. For more information on how we handle data, please view our Privacy Policy.PhoneThis field is for validation purposes and should be left unchanged.