Easydus

First name

Last name

E-mail address

Sex

Address

Postal code

City

Country

Year of birth

Do you use oxygen?

Have you had a lung transplant?

Type of PH

Do you use medication?

PDE-5 inhibitors (Viagra, Revatio, Tadalafil, etc)

ERA (Tracleer, Bosentan, etc)

Selexipag

Riociguat

Prostacyclin (implanted pump)

Prostacyclin (subcutaneous pump)

Prostacyclin (chest catheter)

Other, please specify

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