Spirometry Test Information and Form

If you have been advised by the surgery to do so, please submit this form as soon as you have made your appointment.

Spirometry Test Disclaimer

Patient Details

Please use date format: DD/MM/YYYY

Please indicate which type of spirometry test you have booked: *

Reversibility

Important – please read these Dos and Don’ts at the time of making your appointment for Reversibility Spirometry.

You must bring a blue inhaler to the appointment. If you do not have a blue ‘reliever’ inhaler please contact the Dispensary well in advance of your appointment so one can be issued.

Do

  • Wear loose clothing so that you will feel comfortable and not restricted
  • Visit the toilet to pass urine before your test
  • Please wear correctly fitted dentures if worn

Don't

  • You should wait at least six weeks after eye surgery (cataracts etc) or any abdominal surgery before having this test
  • If you have been taking antibiotics or oral steroids for a recent chest infection, please wait for 4 weeks after completion of the medication before your spirometry
  • You must not attend the appointment if you have any symptoms of COVID-19 or have been in contact with anyone with symptoms of COVID-19 in the past 10 days
  • Don’t eat a large meal or smoke for at least 2 hours before your test
  • Please avoid vigorous exercise prior to the test, we would advise you to attend 5 minutes prior to your appointment to ensure you are rested
  • Please do not drink alcohol on the day of the test

Your Medication - Important

Please continue to take your medication as usual prior to your appointment except:

  • Do not take Salbutamol, (Ventolin) or Terbutaline for 4 hours before your test (6 hours for anticholinergics)
  • Do not take anticholinergics such as ipratripium for 6 hours before your test
  • Do not take Salmeterol or Formoterol or sustained release theophylline for 12 hours before your test

Standard

Important – please read these Dos and Don’ts at the time of making your appointment for Reversibility Spirometry.

You must arrive 20 minutes before your test time to sit in the waiting room to take 4 puffs of your blue ‘reliever’ inhaler. If you do not have a blue ‘reliever’ inhaler please contact the Dispensary well in advance of your appointment so one can be issued.

Do

  • Wear loose clothing so that you will feel comfortable and not restricted
  • Visit the toilet to pass urine before your test
  • Please wear correctly fitted dentures if worn

Don't

  • You should wait at least six weeks after eye surgery (cataracts etc) or any abdominal surgery before having this test
  • If you have been taking antibiotics or oral steroids for a recent chest infection, please wait for 4 weeks after completion of the medication before your spirometry
  • You must not attend the appointment if you have any symptoms of COVID-19 or have been in contact with anyone with symptoms of COVID-19 in the past 10 days
  • Eat a large meal or smoke for at least 2 hours before your test
  • Please avoid vigorous exercise prior to the test
  • Please do not drink alcohol on the day of the test

Your Medication - Important

Please continue to take your medication as usual prior to your appointment.

*