"*" indicates required fields

Step 1 of 6

16%

Do you want relief from your severe COPD/ Emphysema?

Find out if you may qualify for the Zephyr Valve Treatment

Do you have a confirmed diagnosis of COPD or emphysema?*

Yes

No

I don't know

Do you have reduced lung function (FEV1 <50% predicted)?*

Yes

No

I don't know

Are you currently on supplemental oxygen therapy?*

Yes

No

Do you stop to catch your breath often, even with taking your medication as directed?*

Yes

No

Sometimes

Almost done! Your results are next. Sign up to get helpful information about living with severe COPD/Emphysema.

Name

First Last

Email

Zip Code

By completing this form, you agree to receive information from Pulmonx, makers of the Zephyr® Valve. We will not share or sell your personal information. All information is strictly confidential.

US-EN-1074-v1

Hidden

Encrypted last Name

Hidden

unencrypted_last_name

Email

This field is for validation purposes and should be left unchanged.