Kettering Health Network Logo

K For Life Phone Number

Follow Follow Follow Follow Print





A- A A+ Text Size

Lung Screening Quiz

Take the following quiz to see if the pulmonary rehabilitation program could be right for you. Choose the most appropriate answer in each category and click the "Calculate Report" button below to tally your answers.



  1. Do you sometimes have coughing or breathing attacks when exerting yourself - for instance, when walking up stairs, taking a shower?

    Yes   No




  2. Do you smoke? Have you smoked for a long period of time?

    Yes   No




  3. Do you frequently have bronchitis?

    Yes   No




  4. Do you have morning coughing fits?

    Yes   No




  5. Do you cough up mucous daily?

    Yes   No




  6. Does any of the following items limit your ability to remain active?
    Shortness of Breath, Fatigue or Lightheadedness.


    Yes   No




  7. Do you get short of breath during any of the following activities?

    • At rest
    • Eating
    • Simple personal care
    • Taking full bath/shower
    • Dressing
    • Picking up/straightening up
    • Sweeping/vacuuming
    • Shopping Laundry
    • Climbing stairs
    • Cooking/doing dishes
    • Walking around your house
    • Walking at your own pace on level surface
    • Walking one block
    • Walking up a slight hill


    Yes   No




  8. How did you learn of the screening?



    If "Other": 





  9. Image Code:






    Disclaimer: This quiz has been created for educational purposes only and should not be used as a substitute for professional medical advice, diagnosis, treatment, or care. You should always follow your doctor's recommendations regarding your specific medical needs.



    Top of Page

Community Outreach

(937) 558-3988









 
 
Send Me Health information  Sign Up Now For My Chart