To qualify for this study we are looking for individuals who have been
diagnosed with COPD and who have had an exacerbation within the
last 12 months resulting in hospitalization and prescriptions of an antibiotic
or steroid.  Documentation of these events is necessary.

* Required fields
Name *
E-mail Address *
Phone Number: *
Age: *
Have you been diagnosed with COPD for at least one year? *
Have you been hospitalized for an exacerbation of the COPD within the last 12 months? *
Were you prescribed an antibiotic and/ or a steroid at the time of the exacerbation? *
Can you provide written documentation for the events that pertain to you? *

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