Check@ir: assessing your lung health

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Check@ir online

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- Step 1 of 11

Welcome to Checkair

This form will help you assess your respiratory health and identify possible causes of symptoms such as fatigue or shortness of breath.

You just have to follow two simple steps:

STEP 1: Answer the questionnaire

This assessment is quick and easy. Please answer the questions about your symptoms, sensations, and daily habits as objectively as possible. Your answers will be treated with the utmost confidentiality.

STEP 2: Receive your assessment

When you complete and submit the form, you'll receive an email with a report on your respiratory health containing the information you provided, as well as the 2025 Clean Air, Healthy Lives Guide with recommendations to help you start taking better care of yourself and living with peace of mind.

Before continuing, read and accept this information.

Terms and Conditions *

I have read and accept the Legal Notice la Privacy Policy , the Cookies Policy and Terms of Service from the HappyAir Ecosystem

Informed consent *

I authorize the Lovexair Foundation to collect my personal and health data to register them on the HappyAir platform and send me a personalized report via email.
I consent to the use of aggregated information that contributes to research and improvement of the HappyAir Ecosystem. (optional)

Communication *

Yes, I would like to receive more information about the Lovexair Foundation's activities or projects.
No, I do not wish to receive further information.

Select the patient's name

Name *

Name and Surname to avoid duplicate profiles or false registrations

Email address *

We need your email to send you the results of your evaluation.

Date of birth *

Age and gender are important to personalize your health report.

Gender *

Male
Female
I prefer not to say

Country *

City

Postal Code

Where you live can affect your health. Your ZIP code helps us determine this (optional).

Phone

Check@ir completion date *

(DD/MM/YYYY)

DIAGNOSIS

Have you been diagnosed with any respiratory illness? *

What chronic disease have you been diagnosed with? (You can select more than one option. If you have another respiratory problem in addition to Asthma or COPD, tell us by selecting the option "I have another different pathology.") *

Asthma
COPD
I don't know or I'm not sure
I have another different pathology

What other pathology do you have?

Allergy
Sleep Apnea
Bronchiectasis
Lung cancer
Persistent COVID
Alpha-1-Antitrypsin Deficiency
Primary ciliary dyskinesia
neuromuscular disease
Cystic fibrosis
Idiopathic pulmonary fibrosis
Pulmonary hypertension
LAM
sarcoidosis
Chronic cough
lung transplant
Another respiratory problem

Another respiratory problem

asthma control

Evaluate the impact that asthma has on your health by completing the following test.

Asthma Control Assessment Questionnaire

For each question, please check the box that best describes the impact asthma currently has on your daily life.

1. In the last month, how has your asthma been controlled? *

Nada
Evil
Poco
All right
Completely

2. In the last month, how much has asthma prevented you from carrying out activities at your workplace, school or home? *

Very much
Much
Something
A little
Nada

3. In the last month, how often have you felt dyspnea (shortness of breath or shortness of breath)? *

Several times a day
Only 1 time a day
More than 3 times a week
1 to 3 times a week
I have not felt dyspnea

4. In the past month, how often have your asthma symptoms (coughing, shortness of breath, wheezing, or feeling of pressure in your chest) woken you up at night or earlier than usual? *

Almost every night or every night (4 or more) per week
A few times a week (2 or 3)
Once every week
Anytime during the last month (1 or 2)
It hasn't happened to me

5. In the last month, how many times have you had to use your rescue medication? *

Daily: 3 or more times
Daily: 1 or 2 times
No more than 2 or 3 times a week
No more than 1 time per week
I haven't had to use it

Questionnaire result

This test helps us evaluate the control you have had over your asthma during the last month.

result

COPD control

Evaluate the impact that COPD has on your health by completing the following test.

COPD Assessment Test™ (CAT)

This questionnaire will help you and your healthcare professional measure the impact that COPD (chronic obstructive pulmonary disease) is having on your well-being and daily life.

Your answers and test scores can be used by you and your healthcare professional to help improve your management of COPD and get the most benefit from your treatment.

https://www.catestonline.org/patient-site-test-page-spanish-la.html

Cough *

0 I never cough
1
2
3
4
5 I'm always coughing

phlegm *

0 I have no phlegm (mucus) in my chest
1
2
3
4
5 My chest is completely filled with phlegm (mucus)

Chest tightness *

0 I don't feel any tightness in my chest
1
2
3
4
5 I feel a lot of tightness in my chest

feeling short of breath *

0 When I climb a slope or a flight of stairs, I don't run out of breath.
1
2
3
4
5 When I go up a slope or a flight of stairs, I get very short of breath.

Domestic activities *

0 I do not feel limited in carrying out household activities
1
2
3
4
5 I feel very limited to carry out domestic activities

Go out on the street *

0 I feel safe leaving the house despite the lung condition I suffer from
1
2
3
4
5 I don't feel safe at all leaving the house because of the lung condition I suffer from.

Dream *

0 I sleep without problems
1
2
3
4
5 I have trouble sleeping because of the lung condition I suffer from

Power level *

0 I have a lot of energy
1
2
3
4
5 I have no energy

Result

This test tells us what impact COPD has on your daily life

CAT result

SYMPTOM

The appearance of respiratory symptoms, such as coughing or wheezing, may indicate the presence of a respiratory problem. Early diagnosis and appropriate treatment are essential for a good outcome. Would you like to tell us about your situation?

What have you been feeling lately? *

I have not had any symptoms
Chest pain
Fatigue or tiredness (physical)
Fever
Noises in the chest when breathing
Cough
Secretions/phlegm/mucus
Feeling of shortness of breath or dyspnea

What was the color of the secretions?

White / clean
Dark / Dirty

Pay attention to the symptoms!

The presence of respiratory symptoms may be due to a poorly controlled respiratory disease, an exacerbation, or a problem that has not yet been diagnosed.

We recommend that you go to your doctor or consult with one of our HappyAir Coaches by writing to us at info@happyair.org

CRISES AND EXACERBATIONS

Crises or exacerbations are worsening of your respiratory symptoms. Have you had any of these episodes lately?

How many crises or exacerbations have you had in the last year? *

None
1
2
3
4
5 or more

How many times have you been admitted to hospital in the last year as a result of these crises or exacerbations?

None
1
2
3
4
5 or more

MEDICATION

There are many medications that can help you keep your respiratory illness under control, what type of medication have you been prescribed?

Do you use any type of medication to treat your respiratory problems or symptoms? *

What do you use? *

Antibiotics frequently
Maintenance inhaler that I have to take every day
Rescue or relief inhaler that I should take if I have symptoms. (It is usually blue)
Nebulizations
Nasal spray
Biologic therapy: Medication that is given by injection in the hospital or at home
Alternative / natural / homeopathic therapy
Vaccines
Other type of medication or treatment

Check all the options you need.

What other type of treatment have you been prescribed?

How many times have you used rescue medication in the last week? *

I haven't taken it
1 or 2 times
3 or more times

Don't overuse your rescue inhaler!

Frequently needing a rescue inhaler indicates that your breathing problem is not well controlled.

We recommend that you go to your doctor or consult with one of our HappyAir Coaches by writing to us at info@happyair.org

ACTIVE LIFE

Being sedentary can negatively affect your lung and overall health. However, we understand that feeling of shortness of breath can sometimes make it difficult to stay as active as you would like. Does this happen to you?

What is the average amount of time you have spent doing any type of physical exercise, including walking, in the last week? *

More than 30 minutes a day
Less than 30 minutes a day

For your health, keep moving!

Leading a sedentary lifestyle can negatively affect your health. We recommend that you consult your doctor or speak to one of our HappyAir Coaches, who can guide you to exercise safely and in a way that suits your needs.

If you wish, you can request an appointment with one of our physiotherapists by writing to us at info@happyair.org

Do you feel short of breath when exercising? (mMRC Test) *

I only get short of breath when doing intense exercise.
I get short of breath when walking fast on flat ground, or when walking up a slight slope.
I can't keep up with other people my age on flat ground or have to stop to catch my breath when walking at my own pace on flat ground.
I stop to breathe after walking about 100 meters or after walking a few minutes on flat ground.
I have too much shortness of breath to leave the house or have trouble breathing when getting dressed or undressed.

Choose the option that best describes your current situation.

Feeling short of breath is not normal

The feeling of suffocation may be related to a poorly controlled respiratory illness, an exacerbation or even an as yet undiagnosed problem.

We recommend that you consult your doctor or contact one of our HappyAir Coaches by writing to us at info@happyair.org. We are here to help you.

TRIGGERS AND RISK FACTORS

There are many factors that can affect your lung health. Identifying them is key to taking better care of yourself. Would you like to tell us what yours are?

Environmental pollution is one of the most important problems related to the health of our lungs. Do you think that the air in the place where you live could be contaminated? *

Which of these substances, emotions or agents are you most frequently exposed to? *

Family member with liver problems (Alpha-1 deficiency)
Family member with lung problems
Animals
Pollens
Mold and humidity
Irritating substances such as varnishes, paints, perfumes, pesticides
Anxiety
Stress
Tobacco smoke, vapers...
Smoke generated by vehicles
Smoke produced by biomass (wood, coal...)
Other triggers or risk factors

You can select as many answers as you want.

What other risk factors or triggers are you frequently exposed to?

Do you notice that anxiety makes your breathing difficult or altered? *

Yes a lot
A little
Absolutely
I don't know, I haven't stopped to think about it.

Do you notice that stress makes your breathing difficult or altered? *

Yes a lot
A little
Absolutely
I don't know, I haven't stopped to think about it.

Do you smoke and/or vape? *

Yes I smoke or vape
I don't smoke or vape, but I have done so before.
I have never smoked or vaped
No, but I am a passive smoker

Stay away from tobacco smoke and vaping!

Smoking and vaping are among the main causes of respiratory illnesses and their worsening. Quitting this habit would be an important step towards improving your health.

We recommend that you consult your doctor or speak to one of our HappyAir Coaches, who can help you in this process. If you wish, you can request an appointment by writing to us at info@happyair.org. We are here for you!

We have already finished!

Please make sure you have answered all the questions correctly before submitting the form.

If you wish, you can add any comments that you think may be interesting to share with your doctor or with the HappyAir Coaches.

CREDITS

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