COPD Assessment Form

This questionnaire will help you and your healthcare professional measure the impact COPD (Chronic Obstructive Pulmonary Disease) is having on your wellbeing and daily life. Your answers, and test score, can be used by you and your healthcare professional to help improve the management of your COPD and get the greatest benefit from treatments.

Last Updated: 16/09/2021

Your Details





How is your COPD? Take the COPD Assessment Test (CAT)

For each item below, place a mark (X) in the box that best describes you currently. Be sure to only select one response for each question.









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