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Lungs Health Evaluation
Do you smoke cigarettes?
How many cigarettes a day?
Less than a pack
More than one pack
Date of Birth
Are you suffering from a medical condition, illness, or injury?
Do you have trouble breathing or have heaviness of breath?
How long have you been smoking?
Less than a Year
2 to 5 Years
More than 5 years
Do you do any physical exercise?
Any more information you wish to provide?
I agree to the terms & conditions