COPD clinical trial

ELIGIBILITY & REQUIREMENTS

Aged 40+
Current diagnosis of COPD
Have experienced recent changes or worsening in breathing
Are interested in access to expert clinical care

Complete the form below to register and one of our friendly staff will contact you soon.

How did you find us?
Do you smoke cigarettes now, or have you smoked in the past?
In the past year, how many times have your breathing symptoms suddenly gotten worse (flare-ups) needing extra medicine, a doctor visit, or hospital stay?
Please list below the current medications you take for your COPD (e.g. puffers, antibiotic, steroids)
Do you currently have any of the following conditions? (tick all that apply)

Asthma as your main breathing problem
Lung infection (like pneumonia or tuberculosis)
Serious heart problems (recent heart attack or uncontrolled heart failure)
Cancer or are on cancer treatment right now
None of these

COPD clinical trial

ELIGIBILITY & REQUIREMENTS

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