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The questionnaire.
| Race (circle one) | Caucasian | African American |
|---|---|---|
| Today, do you have any of the following: | ||
| • Chest pain | No | Yes |
| • Cough | No | Yes |
| • Phlegm | No | Yes |
| • Throat hurts | No | Yes |
| • Can’t breathe | No | Yes |
| • Feel tired | No | Yes |
| • Feel dizzy | No | Yes |
| • Wheezing | No | Yes |
| • Woke up within last 2 nights | No | Yes |
| • Can’t do what I want last 2 days | No | Yes |
| • Trouble talking | No | Yes |
| Please rate your breathing from 0 (absolutely normal) to 10 (as bad as it gets): |
