Join Breathing Buddies You must have JavaScript enabled to use this form. Become a Breathing Buddies member today and join a robust community of patients and caregivers who connect, empower and inspire one another. Offering you and your loved ones an abundance of free resources, including access to exclusive news and research updates, Breathing Buddies is here to help you breathe easier. Required Field First Name Last Name Address City State - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederate States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zipcode Phone (xxx-xxx-xxxx) Email Address How are you affected by lung disease? - Select -PatientFamily/Friend/Caregiver Disease Type - Select -Alpha-1 Antitrypsin DeficiencyAsthmaBronchiectasisChronic BronchitisCOPDEmphysemaLung CancerPulmonary Fibrosis (including IPF)Pulmonary HypertensionSarcoidosisSleep ApneaOther/Not Sure Please specify I would like to... (check all that apply) Be connected with other Breathing Buddies. Share my story. Help new patients feel welcome at the Temple Lung Center while I am visiting the facility. Participate in events and support groups in my community. Connect with other patients online. (i.e. message boards, blogs & social communities) Participate in market research or focus groups. I am interested in the following... (check all that apply) Clinical Trials Emotional Support Patient/Caregiver Stories Quality of Life Issue Other Please share your additional interests. I currently... (check all that apply) Use Facebook Use Twitter Use Instagram Have a personal blog Currently Interested in Would Like to By completing this form, you are agreeing to receive communications from the Temple Lung Center. You can opt-out at any time. By submitting this form, you are agreeing to our Terms of Use. Leave this field blank
