BLF Short survey Question Title * 1. What is your gender? Female Male Other (specify) OK Question Title * 2. How old are you? Under 18 18-24 25-34 35-44 45-54 55-64 65+ OK Question Title * 3. What is your smoking status? Current smoker Ex-smoker Never smoked Don't know OK Question Title * 4. What best describes your current employment status? Working full time Working part time Homemaker Student Retired Unemployed Don't know OK Question Title * 5. Do you experience any of the following symptoms on a daily basis? Shortness of breath Flare-up/exacerbation Chronic cough Excess mucus Physical fatigue Sleep disturbance Incontinence (due to COPD symptoms) OK Question Title * 6. What best describes your experiences related to your specific COPD symptoms during the past 7 days? All Mild Moderate Severe Very Severe OK DONE