Please take a few minutes to complete the following survey on airway clearance. The results of this survey will help inform clinicians who are treating patients like you and will help inform industry and regulators as new therapies are developed.

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* 1. I have been diagnosed with these lung conditions (please check all that apply):

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* 2. My gender is

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* 3. My age is:

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* 4. Which race/ethnicity best describes you? (Please choose only one)

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* 5. In which country do you currently reside?

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* 6. Did your doctor recommend that you start doing airway clearance therapy (ACT)?

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* 7. Are you currently doing ACT?

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* 8. How often is your ACT discussed during your CF visits?

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* 9. Which airway clearance method(s) are you currently using? (Please select all that apply)

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* 10. Which of the following are part of your routine?

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* 11. How many times per day do you do your airway clearance?

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* 12. To what extent do you agree or disagree with each of the following statements? Check the box that applies to each statement.

  Not at All True A Bit True Occasionally True Somewhat True Completely True N/A
I understand what airway clearance is
I am not able to explain the benefits of airway clearance
I believe airway clearance is an important part of my care routine and makes me healthier.
I am not aware of all the  airway clearance options  that are available to me.
I am willing to work closely with my care team to find the airway clearance routine that is best for me.
My airway clearance skills need improvement.
I consistently do my airway clearance routine each day.
I am unhappy/dissatisfied with my current airway clearance routine.
I continue doing my airway clearance routine when I am traveling.
I am not comfortable doing airway clearance in front of friends.
I am able to set aside time each day to perform airway clearance.
I am able to find the time each day to perform airway clearance. 
My airway clearance routine gets in the way of doing things I want to accomplish each day.

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* 13. Which of the following might get in the way of doing your current airway clearance routine or adding a new airway clearance option? (Check all items that apply)

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* 14. Use this space to add any thoughts about airway clearance not addressed in the sections above.

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* 15. Would you be interested in participating in a public health panel to help provide educational material for the CF community in the future? If so, please enter your email address below.

Thank you for taking the time to complete this survey. We appreciate the time you have taken to help us better understand your needs and preferences with airway clearance.

Please proceed to the next screen to submit your survey responses.
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