Cough Severity Index (CSI) My cough is worse when I lie down 0 1 2 3 4 None My coughing problem causes me to restrict my personal and social life. 0 1 2 3 4 None I tend to avoid places because of my cough problem. 0 1 2 3 4 None I feel embarrassed because of my coughing problem. 0 1 2 3 4 None People ask, “What’s wrong?” Because I cough a lot. 0 1 2 3 4 None I run out of air when I cough. 0 1 2 3 4 None My coughing problem affects my voice. 0 1 2 3 4 None My coughing problem limits my physical activity 0 1 2 3 4 None My coughing problem upsets me 0 1 2 3 4 None People ask me if I am sick because I cough a lot. 0 1 2 3 4 None First Name Surname DOB Email Phone number Please contact me by email Please contact me by phone Time's up
