Telephone 02 4822 7788
Goulburn

Clinton Medical Centre

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Survey

Identifying COPD in patients

Are you 35 years of age or older and …

Smoker or ex smoker Yes or No
Work or worked in a job with exposure to dust, gas or fumes Yes or No
Cough several times most days Yes or No
Cough up phlegm or mucus most days Yes or No
Get out of breath more easily than others of a similar age Yes or No
Have frequent chest infections Yes or No

If you answer yes to any of these questions, please check with your doctor.

Cardiovascular Disease (CVD)

Who should have the Australian Cardiovascular Risk Assessment
Are you one of the below?

Aged 45 to 74 and not existing Cardiovascular disease (Heart condition, High blood pressure) or not already known to be at increased risk of CVD. Yes or No
Aboriginal and Torres Strait Islander Adults aged 35 years or older Yes or No

If you answered yes to any of these questions, then see your doctor to check your risk of Cardiovascular disease.

Diabetes

Please take the Diabestes Risk Assessment Tool from the Australia Government Health Website.

Disturbed Sleep leading to Fatigue – Sleep Apnoea and Obstructive airways

Do you Doze when:

Sitting and reading Yes or No
Watching television Yes or No
Sitting inactive in a public place (eg: movies, Meeting) Yes or No
As a passenger in a car for an hour without a break Yes or No
Lying down to rest in the afternoon, when the circumstances permit Yes or No
Sitting and talking to someone Yes or No
Sitting quietly after lunch without alcohol Yes or No
In a car, while stopped for a few minutes Yes or No

If you answer yes to 3 of these questions, Then see your doctor to check.

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304-308 Auburn Street
Goulburn New South Wales 2580

Telephone 02 4822 7788
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