1. This survey will take approximately 25 minutes to complete and should be done in one sitting.

Informed Consent Statement

Purpose: The purpose of this survey is to gather information from patients with lung disease who require supplemental oxygen. We wish to better understand how patients are receiving oxygen, and how it is being paid for. Please complete the survey regardless of whether you are experiencing any problems.

Your identity and individual responses will not be released or shared with any group except for the Pulmonary Fibrosis Foundation (PFF). You will be assigned a code number; no personally identifiable information will be published in any form. Your name, zip code, and email are requested so that we can follow up with you after this survey to monitor any changes to your oxygen supply or services on an ongoing basis. If you agree to participate in this survey, you may be contacted again to participate in a short follow up survey. 

Completing this survey is voluntary. The survey will take approximately 25 minutes to complete and should be completed in one sitting; you cannot save the survey and come back to it. If there are questions that you prefer not to answer, you do not have to answer them.

This survey was developed by the PFF. If you have any questions about this survey you may contact the PFF Patient Communication Center at 844.825.5733 or pcc@pulmonaryfibrosis.org.