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Connective Tissue Disease - Interstitial Lung Disease

UCLA Connective Tissue Disease -
Interstitial Lung Disease Program

Connective Tissue Disease - Interstitial Lung Disease
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UCLA Connective Tissue Disease -
Interstitial Lung Disease Program

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Questionnaires

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CTD-ILD Program Questionnaires


The following questionnaires will assess your symptoms related to CTD-ILD.

Please print and complete these forms prior to your visit.

You can bring these questionnaires with you to your appointment or you can fax them to our office prior to your appointment at fax no. (310) 206-5088.

  • Connective tissue disease screening questionnaire (PDF)
  • Dyspnea questionnaire (PDF)
  • Health assessment questionnaire (PDF)
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