Patient & Caregiver Network | American Lung Association

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href="https://action.lung.org/site/Donation2?df_id=31271&mfc_pref=T&31271.donation=form1" data-parent="" data-navtype="header">One-Time Gift</a> </li> <li class=" "> <a class="nav-item " href="https://action.lung.org/site/Donation2?df_id=31270&mfc_pref=T&31270.donation=form1" data-parent="" data-navtype="header">Monthly</a> </li> <li class=" "> <a class="nav-item " href="https://action.lung.org/site/Donation2?df_id=31272&mfc_pref=T&31272.donation=form1" data-parent="" data-navtype="header">Honor & Memorial</a> </li> </ul> </li> <li class=" "> <a class="nav-item has-dropdown " href="https://legacy.lung.org/" data-parent="" data-navtype="header">Legacy Giving</a> <ul class="primary-nav-submenu js-nav-dropdown-toggle"> <li class=" "> <a class="nav-item " href="https://legacy.lung.org/gifts-of-securities" data-parent="" data-navtype="header">Gifts of Stock</a> </li> <li class=" "> <a class="nav-item " href="https://legacy.lung.org/gifts-from-donor-advised-funds" data-parent="" 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target=""_blank"" data-parent="" data-navtype="header">SMASH the Stats</a> </li> <li class=" "> <a class="nav-item external " href="https://bealungsaver.funraise.org/" target=""_blank"" data-parent="" data-navtype="header">Be a Lung-Saver</a> </li> <li class=" "> <a class="nav-item external " href="https://poweredbylungs.funraise.org/" target=""_blank"" data-parent="" data-navtype="header">Powered By Lungs</a> </li> <li class=" "> <a class="nav-item external " href="https://tiltify.com/american-lung-association" target=""_blank"" data-parent="" data-navtype="header">Livestream for Lungs</a> </li> <li class=" view-more"> <a class="nav-item view-more view-more" href="/get-involved/ways-to-give/diy" data-parent="" data-navtype="header">View More</a> </li> </ul> </li> <li class=" "> <a class="nav-item external " href="https://wallofremembrance.funraise.org/" target=""_blank"" data-parent="" data-navtype="header">Create a Memorial Wall</a> </li> </ul> </li> <li class=" col-lg-3"> <ul 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Check to see if your donation is eligible. </p> </div> </a> </li> </ul> </li> </ul> </li> <li class="menu-item-cta"> <a id="donateBtn" href="/donate" class="header-donate btn secondary-btn homeDonateBtn">Donate</a> </li> </ul> <ul class="nav-utilities"> <li> <div class="nav-location"> Location: <span class="mobile-location-info notranslate"></span> <a href="#" class="js-location-modal">Update</a> </div> </li> <li><a href="https://shop.lung.org/ala_shop/shop/home" class="external" target=""_blank"">Shop</a></li> <li><a href="/blog" class="">Blog</a></li> <li><a class="notranslate" href="/lung-force">LUNG FORCE</a></li> <li><a href="/help-support" class="">Help & Support</a></li> <li><a href="/signin">Login</a></li> <li> <div class="nav-language"> <a href="#" class="js-language-modal btn primary-btn translate-btn mobile">Translate</a> </div> </li> </ul> </div> </nav> </header> <main id="main" class="main" data-swiftype-name="body" data-swiftype-type="text"> <div 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class="global-container"> <div class="promo-card-content"> <div class="promo-card-content-wrap"> <h1>Patient & Caregiver Network</h1> The Patient & Caregiver Network is a nationwide, online support program providing direct access to lung disease management tools, education, and connection to other patients and caregivers. </div> <ul class="social-icons a2a_kit a2a_kit_size_32 a2a_default_style"> <li> <a href="#" class="social icon-facebook a2a_button_facebook"> <span class="sr-only">Facebook</span> </a> </li> <li> <a class="social icon-twitter a2a_button_twitter"> <span class="sr-only">Twitter</span> </a> </li> <li> <a class="social icon-linkedin a2a_button_linkedin"> <span class="sr-only">LinkedIn</span> </a> </li> <li> <a class="social icon-email a2a_button_email"> <span class="sr-only">Email</span> </a> </li> <li> <a class="social icon-print a2a_button_print"> <span class="sr-only">Print</span> </a> </li> </ul> </div> </div> <div class="promo-card-img corner-img responsive-image_hero "> </div> </div> </section> <section class="section bg-white "> <div class="global-container "> <div class="row"> <div class="col-lg-3"> <div class="side-menu-wrap"> <button class="btn primary-btn js-toggle-side-menu hide-desktop" type="button">Section Menu <span class="icon-angle-down"></span></button> <aside class="side-menu js-side-menu"> <a href="/help-support"> <h3 class="side-menu-heading">Help & Support</h3> </a> <ul class="side-menu-primary "> <li class=" "> <a href="/help-support/lung-helpline-and-tobacco-quitline">Lung Helpline and Tobacco Quitline</a> </li> <script> </script> <li class="active "> <a href="/help-support/patient-caregiver-network">Patient & Caregiver Network</a> <ul class="side-menu-submenu"> <li class=" "> <a href="/help-support/patient-caregiver-network/members">Member Center</a> </li> <script> </script> <li class=" "> <a href="/help-support/patient-caregiver-network/online-support-communities">Online Support Communities</a> </li> <script> </script> <li class=" "> <a href="/help-support/patient-caregiver-network/lung-cancer-mentor">Lung Cancer Mentor Program</a> </li> <script> </script> <li class=" "> <a href="/help-support/patient-caregiver-network/lung-cancer-support-groups">Lung Cancer Support Groups</a> </li> <script> </script> <li class=" hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren hide-sidechildren"> <a href="/help-support/patient-caregiver-network/breath-imagery-sample">Sample Wellness Hub Practice: Breath Imagery</a> </li> <script> </script> </ul> </li> <script> </script> <li class=" "> <a href="/help-support/better-breathers-club">Better Breathers Club</a> </li> <script> </script> <li class=" "> <a href="/help-support/financial-assistance-programs">Financial Assistance Programs</a> </li> <script> </script> <li class=" "> <a href="/help-support/education-programs">Education Programs</a> </li> <script> </script> <li class=" "> <a href="/help-support/corporate-wellness">Corporate Wellness</a> </li> <script> </script> </ul> </aside> </div> </div> <div class="section-general-content col-lg-9 section-general-content-body"> <section class=" no-padding center " style="" id="section_4b4f9129a7c4"> <div class="global-container"> <div class="row "> <div class="col-12"> <div class="card-info card bg-accent"> <div class="card-content center "> <h2 class="card-title">Not Yet A Member?</h2> <div class="card-summary"> <p>Membership is free and will provide you direct access to education, support and connection to others also living with lung disease.</p><p><a class="btn primary-btn" href="#pcn-signup">Join Today</a></p> </div> </div> </div> </div> </div> </div> </section> <section class=" " style="" id="section_02cfaa76c98f"> <div class="global-container"> <div class="row "> <div class="col-12"> <div class="fr-view"> <h2 class="h3">Whether you're a patient with lung disease or a caregiver, members will have access to:</h2> </div> </div> </div> </div> </section> <section class=" no-padding center " style="" id="section_95bb07ca0a6e"> <div class="global-container"> <div class="row "> <div class="col-12"> <div class="fr-view"> <div class="row justify-content-center"><div class="col-md-4 col-sm-4 col-lg"><div class="card-body" style="padding: 15px 0"><span class="card-icon small-icon center icon-group-of-people" style="margin-bottom: 10px"> </span><p class="no-margin" style="color: rgba(13, 35, 84, 1); line-height: 1.36"><strong>Wellness Hub</strong></p></div></div><div class="col-md-4 col-sm-4 col-lg"><div class="card-body" style="padding: 15px 0"><span class="card-icon small-icon center icon-people-group" style="margin-bottom: 10px"> </span><p class="no-margin" style="color: rgba(13, 35, 84, 1); line-height: 1.36"><strong>Disease-specific Online Communities</strong></p></div></div><div class="col-md-4 col-sm-4 col-lg"><div class="card-body" style="padding: 15px 0"><span class="card-icon small-icon center icon-monitor" style="margin-bottom: 10px"> </span><p class="no-margin" style="color: rgba(13, 35, 84, 1); line-height: 1.36"><strong>On-Demand Webcasts</strong></p></div></div><div class="col-md-4 col-sm-4 col-lg"><div class="card-body" style="padding: 15px 0"><span class="card-icon small-icon center icon-shared-story" style="margin-bottom: 10px"> </span><p class="no-margin" style="color: rgba(13, 35, 84, 1); line-height: 1.36"><strong>Live Webcasts</strong></p></div></div><div class="col-md-4 col-sm-4 col-lg"><div class="card-body" style="padding: 15px 0"><span class="card-icon small-icon center icon-lungs" style="margin-bottom: 10px"> </span><p class="no-margin" style="color: rgba(13, 35, 84, 1); line-height: 1.36"><strong>Lung Disease Management Tools</strong></p></div></div><div class="w-100 d-none d-lg-block"> </div></div> </div> </div> </div> </div> </section> <section class=" " style="" id="section_e3fb02fa8e6f"> <div class="global-container"> <div class="row "> <div class="col-12"> <div class="card-info card bg-accent"> <div class="card-content center "> <h2 class="card-title">Already A Member?</h2> <div class="card-summary"> <p>Explore your one-of-a-kind Resource Center for breathwork practices, discussion groups, movement classes, tools to manage your lung disease, and more.</p><p><a class="btn primary-btn" href="/help-support/patient-caregiver-network/members">Resource Center</a></p> </div> </div> </div> </div> </div> </div> </section> <section class=" padding-top no-padding-bottom center " style=""> <div class="global-container"> <div class="row "> <div class="col-12"> <div class="fr-view"> <h2 class="h3 pb-3 pb-md-4 mx-auto col-md-10">Learn more about the Patient & Caregiver Network</h2> </div> </div> </div> </div> </section> <section class=" double-padding-bottom no-padding-top " style=""> <div class="global-container"> <div class="row "> <div class="col-12"> <div class="card widget widget-video"> <a href="https://www.youtube.com/embed/3W_Nve6Ztxk" class="video"> <div class="card-img" style="background-image:url('/optimize/getmedia/3671188c-4fac-4b90-806c-41e052ac2f4b/bbn-video-k.jpg?format=webp')"> <span class="icon-play"></span> <span class="sr-only">iframe video</span> </div> </a> <div class="widget-caption"> <p>The Patient & Caregiver Network provides individuals living with lung disease and their families timely support, education and access to emerging research like clinical trials. Joining is easy!</p> <a class="widget-video-cta video" href="https://www.youtube.com/embed/3W_Nve6Ztxk">Watch Video <span class="icon-play"></span></a> </div> </div> </div> </div> </div> </section> <section class=" " style="" id="section_70cdea73a4d5"> <div class="global-container"> <div class="row "> <div class="col-12"> <div id="promo-zmlo2g5hxce" class="icon-cta-card card-symbol card widget bg-accent position-left-align icon-size-large "> <div class="card-content"> <span class="card-icon icon-people-group"></span> <h2 class="card-title no-margin">Lung Cancer Support Groups</h2> <div class="card-summary"> Lung cancer patients and their families have many needs as they deal with the challenges of navigating lung cancer. An opportunity to connect with peers in-person can help lower stress levels and improve coping skills. </div> <a class="cta-link primary-btn " href="/help-support/patient-caregiver-network/lung-cancer-support-groups"> Learn more </a> </div> </div> </div> </div> </div> </section> <section class=" double-padding-bottom padding-top " style="" id="bbn-event-widget"> <div class="global-container"> <div class="row "> <div class="col-12"> <div class="widget widget--event"> <div class="event-widget-wrap bg-gray padding-top padding-bottom"> <div class="event-widget-intro global-container center"> <h2 class="h3">Upcoming Virtual Webcasts</h2> </div> <div id="event-list-app" class="filter-app event-widget "> <app v-bind:filterid="'event-list-app'" v-bind:filtertype="'eventwidgetfilter'" v-bind:result="{"PageIndex":0,"PageSize":10,"Facets":null,"Items":[],"RowEnd":0,"RowStart":0,"Specification":{"Categories":["BetterBreathersNetwork"],"IncludeCurrentEvents":true,"Chronological":false,"Sort":"Upcoming","PageIndex":0,"PageSize":10,"StartingAfter":null,"StartingBefore":"2026-02-17T23:59:59","StateCode":null,"IsVirtual":false,"ExcludedCategories":null},"Total":0,"TotalResults":0,"TotalPages":0}" v-bind:showhero="false" v-bind:showfilters="true" v-bind:shownationwide="false" v-bind:noresultsmsg="'v-bind:noresultsmsg'" v-bind:showctatext="true"> <section class="cards card--list section bg-white"> </section> </app> </div> </div> </div> <script> window.Launchpad = window.Launchpad || {}; 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Signing up for the network is free and will provide you direct access to education, support and connection to others also living with chronic lung disease.</p><p class="footnote"><strong>Required fields marked with an asterisk (*)</strong></p> </div> <div class="form" id="form-BetterBreathersClubNoLocalClubAvailable-8439_wrapper-fd35bb90-0888-4e76-9bb1-74d29de19457"><div><form action="/Kentico.Components/en-US/Kentico.FormWidget/KenticoFormWidget/FormSubmit?formName=BetterBreathersClubNoLocalClubAvailable&prefix=form-BetterBreathersClubNoLocalClubAvailable-8439&displayValidationErrors=False" data-ktc-ajax-update="form-BetterBreathersClubNoLocalClubAvailable-8439_wrapper-fd35bb90-0888-4e76-9bb1-74d29de19457" id="form-BetterBreathersClubNoLocalClubAvailable-8439" method="post" onsubmit="window.kentico.updatableFormHelper.submitForm(event);"> <div class="row"> <div class="col-12 col-sm-6"> <div class="form-field"> <label class="control-label required required-field-red-star" for="form-BetterBreathersClubNoLocalClubAvailable-8439_FirstName_Value">First Name</label> <div class="editing-form-control-nested-control"> <input aria-required="true" class="form-control text-input required" data-ktc-notobserved-element="" data-validate-id="textComponent-ylzhshpssm2" id="form-BetterBreathersClubNoLocalClubAvailable-8439_FirstName_Value" name="form-BetterBreathersClubNoLocalClubAvailable-8439.FirstName.Value" type="text" value=""> <div class="error empty hidden"> Please complete the field above </div> <div class="error email hidden"> Please enter a valid email </div> <div class="error emailplus hidden"> Email address cannot contain '+' symbols </div> <div class="error phone hidden"> Please enter a valid phone number </div> <div class="error zipcode hidden"> Please enter your zipcode in ##### or #####-#### format </div> <script type="text/javascript"> if (document.readyState === "loading") { // Calls the function during the 'DOMContentLoaded' event, after the HTML document has been completely loaded document.addEventListener("DOMContentLoaded", function () { if (window.FormTools == null) return; FormTools.setDynamic("input[data-validate-id='textComponent-ylzhshpssm2']"); }); } else if (window.FormTools != null) { // Calls the function directly in cases where the widget is rendered dynamically after 'DOMContentLoaded' has occurred FormTools.setDynamic("input[data-validate-id='textComponent-ylzhshpssm2']"); } </script> <div class="field-validation-valid" data-valmsg-for="form-BetterBreathersClubNoLocalClubAvailable-8439.FirstName.Value" data-valmsg-replace="true"></div><div class="field-validation-valid" data-valmsg-for="form-BetterBreathersClubNoLocalClubAvailable-8439.FirstName" data-valmsg-replace="true"></div> </div> </div> </div> <div class="col-12 col-sm-6"> <div class="form-field"> <label class="control-label required required-field-red-star" for="form-BetterBreathersClubNoLocalClubAvailable-8439_LastName_Value">Last Name</label> <div class="editing-form-control-nested-control"> <input aria-required="true" class="form-control text-input required" data-ktc-notobserved-element="" data-validate-id="textComponent-dojg4iztp2p" id="form-BetterBreathersClubNoLocalClubAvailable-8439_LastName_Value" name="form-BetterBreathersClubNoLocalClubAvailable-8439.LastName.Value" type="text" value=""> <div class="error empty hidden"> Please complete the field above </div> <div class="error email hidden"> Please enter a valid email </div> <div class="error emailplus hidden"> Email address cannot contain '+' symbols </div> <div class="error phone hidden"> Please enter a valid phone number </div> <div class="error zipcode hidden"> Please enter your zipcode in ##### or #####-#### format </div> <script type="text/javascript"> if (document.readyState === "loading") { // Calls the function during the 'DOMContentLoaded' event, after the HTML document has been completely loaded document.addEventListener("DOMContentLoaded", function () { if (window.FormTools == null) return; FormTools.setDynamic("input[data-validate-id='textComponent-dojg4iztp2p']"); }); } else if (window.FormTools != null) { // Calls the function directly in cases where the widget is rendered dynamically after 'DOMContentLoaded' has occurred FormTools.setDynamic("input[data-validate-id='textComponent-dojg4iztp2p']"); } </script> <div class="field-validation-valid" data-valmsg-for="form-BetterBreathersClubNoLocalClubAvailable-8439.LastName.Value" data-valmsg-replace="true"></div><div class="field-validation-valid" data-valmsg-for="form-BetterBreathersClubNoLocalClubAvailable-8439.LastName" data-valmsg-replace="true"></div> </div> </div> </div> </div> <div class="ktc-default-section"> <div class="form-field"> <label class="control-label required required-field-red-star" for="form-BetterBreathersClubNoLocalClubAvailable-8439_Email_Email">Email</label> <div class="editing-form-control-nested-control"> <input aria-required="true" class="form-control" data-ktc-notobserved-element="" id="form-BetterBreathersClubNoLocalClubAvailable-8439_Email_Email" name="form-BetterBreathersClubNoLocalClubAvailable-8439.Email.Email" type="email" value=""> <div class="field-validation-valid" data-valmsg-for="form-BetterBreathersClubNoLocalClubAvailable-8439.Email.Email" data-valmsg-replace="true"></div><div class="field-validation-valid" data-valmsg-for="form-BetterBreathersClubNoLocalClubAvailable-8439.Email" data-valmsg-replace="true"></div> </div> </div> </div> <div class="ktc-default-section"> <div class="form-field"> <label class="control-label required required-field-red-star" for="form-BetterBreathersClubNoLocalClubAvailable-8439_Street1_Value">Address Line 1</label> <div class="editing-form-control-nested-control"> <input aria-required="true" class="form-control text-input required" data-ktc-notobserved-element="" data-validate-id="textComponent-s2pbbzz44wl" id="form-BetterBreathersClubNoLocalClubAvailable-8439_Street1_Value" name="form-BetterBreathersClubNoLocalClubAvailable-8439.Street1.Value" type="text" value=""> <div class="error empty hidden"> Please complete the field above </div> <div class="error email hidden"> Please enter a valid email </div> <div class="error emailplus hidden"> Email address cannot contain '+' symbols </div> <div class="error phone hidden"> Please enter a valid phone number </div> <div class="error zipcode hidden"> Please enter your zipcode in ##### or #####-#### format </div> <script type="text/javascript"> if (document.readyState === "loading") { // Calls the function during the 'DOMContentLoaded' event, after the HTML document has been completely loaded document.addEventListener("DOMContentLoaded", function () { if (window.FormTools == null) return; FormTools.setDynamic("input[data-validate-id='textComponent-s2pbbzz44wl']"); }); } else if (window.FormTools != null) { // Calls the function directly in cases where the widget is rendered dynamically after 'DOMContentLoaded' has occurred FormTools.setDynamic("input[data-validate-id='textComponent-s2pbbzz44wl']"); } </script> <div class="field-validation-valid" data-valmsg-for="form-BetterBreathersClubNoLocalClubAvailable-8439.Street1.Value" data-valmsg-replace="true"></div><div class="field-validation-valid" data-valmsg-for="form-BetterBreathersClubNoLocalClubAvailable-8439.Street1" data-valmsg-replace="true"></div> </div> </div> </div> <div class="ktc-default-section"> <div class="form-field"> <label class="control-label" for="form-BetterBreathersClubNoLocalClubAvailable-8439_Street2_Value">Address Line 2 (Optional)</label> <div class="editing-form-control-nested-control"> <input class="form-control text-input " data-ktc-notobserved-element="" data-validate-id="textComponent-cyd3zezlfvj" id="form-BetterBreathersClubNoLocalClubAvailable-8439_Street2_Value" name="form-BetterBreathersClubNoLocalClubAvailable-8439.Street2.Value" type="text" value=""> <div class="error empty hidden"> Please complete the field above </div> <div class="error email hidden"> Please enter a valid email </div> <div class="error emailplus hidden"> Email address cannot contain '+' symbols </div> <div class="error phone hidden"> Please enter a valid phone number </div> <div class="error zipcode hidden"> Please enter your zipcode in ##### or #####-#### format </div> <script type="text/javascript"> if (document.readyState === "loading") { // Calls the function during the 'DOMContentLoaded' event, after the HTML document has been completely loaded document.addEventListener("DOMContentLoaded", function () { if (window.FormTools == null) return; FormTools.setDynamic("input[data-validate-id='textComponent-cyd3zezlfvj']"); }); } else if (window.FormTools != null) { // Calls the function directly in cases where the widget is rendered dynamically after 'DOMContentLoaded' has occurred FormTools.setDynamic("input[data-validate-id='textComponent-cyd3zezlfvj']"); } </script> <div class="field-validation-valid" data-valmsg-for="form-BetterBreathersClubNoLocalClubAvailable-8439.Street2.Value" data-valmsg-replace="true"></div><div class="field-validation-valid" data-valmsg-for="form-BetterBreathersClubNoLocalClubAvailable-8439.Street2" data-valmsg-replace="true"></div> </div> </div> </div> <div class="row"> <div class="col-12 col-sm-4"> <div class="form-field"> <label class="control-label required required-field-red-star" for="form-BetterBreathersClubNoLocalClubAvailable-8439_City_Value">City</label> <div class="editing-form-control-nested-control"> <input aria-required="true" class="form-control text-input required" data-ktc-notobserved-element="" data-validate-id="textComponent-kdqdjqpon1g" id="form-BetterBreathersClubNoLocalClubAvailable-8439_City_Value" name="form-BetterBreathersClubNoLocalClubAvailable-8439.City.Value" type="text" value=""> <div class="error empty hidden"> Please complete the field above </div> <div class="error email hidden"> Please enter a valid email </div> <div class="error emailplus hidden"> Email address cannot contain '+' symbols </div> <div class="error phone hidden"> Please enter a valid phone number </div> <div class="error zipcode hidden"> Please enter your zipcode in ##### or #####-#### format </div> <script type="text/javascript"> if (document.readyState === "loading") { // Calls the function during the 'DOMContentLoaded' event, after the HTML document has been completely loaded document.addEventListener("DOMContentLoaded", function () { if (window.FormTools == null) return; FormTools.setDynamic("input[data-validate-id='textComponent-kdqdjqpon1g']"); }); } else if (window.FormTools != null) { // Calls the function directly in cases where the widget is rendered dynamically after 'DOMContentLoaded' has occurred FormTools.setDynamic("input[data-validate-id='textComponent-kdqdjqpon1g']"); } </script> <div class="field-validation-valid" data-valmsg-for="form-BetterBreathersClubNoLocalClubAvailable-8439.City.Value" data-valmsg-replace="true"></div><div class="field-validation-valid" data-valmsg-for="form-BetterBreathersClubNoLocalClubAvailable-8439.City" data-valmsg-replace="true"></div> </div> </div> </div> <div class="col-12 col-sm-4"> <div class="form-field"> <label class="control-label required required-field-red-star" for="form-BetterBreathersClubNoLocalClubAvailable-8439_State_Value">State</label> <div class="editing-form-control-nested-control"> <div class=""> <select data-ktc-notobserved-element="" data-live-search="true" id="dropdownComponent-cvcvgjv2snr" name="form-BetterBreathersClubNoLocalClubAvailable-8439.State.Value"> <option value="">Please Select</option> <option value="AL">Alabama</option> <option value="AK">Alaska</option> <option value="AZ">Arizona</option> <option value="AR">Arkansas</option> <option value="CA">California</option> <option value="CO">Colorado</option> <option value="CT">Connecticut</option> <option value="DE">Delaware</option> <option value="DC">District of Columbia</option> <option value="FL">Florida</option> <option value="GA">Georgia</option> <option value="HI">Hawaii</option> <option value="ID">Idaho</option> <option value="IL">Illinois</option> <option value="IN">Indiana</option> <option value="IA">Iowa</option> <option value="KS">Kansas</option> <option value="KY">Kentucky</option> <option value="LA">Louisiana</option> <option value="ME">Maine</option> <option value="MD">Maryland</option> <option value="MA">Massachusetts</option> <option value="MI">Michigan</option> <option value="MN">Minnesota</option> <option value="MS">Mississippi</option> <option value="MO">Missouri</option> <option value="MT">Montana</option> <option value="NE">Nebraska</option> <option value="NV">Nevada</option> <option value="NH">New Hampshire</option> <option value="NJ">New Jersey</option> <option value="NM">New Mexico</option> <option value="NY">New York</option> <option value="NC">North Carolina</option> <option value="ND">North Dakota</option> <option value="OH">Ohio</option> <option value="OK">Oklahoma</option> <option value="OR">Oregon</option> <option value="PA">Pennsylvania</option> <option value="PR">Puerto Rico</option> <option value="RI">Rhode Island</option> <option value="SC">South Carolina</option> <option value="SD">South Dakota</option> <option value="TN">Tennessee</option> <option value="TX">Texas</option> <option value="UT">Utah</option> <option value="VT">Vermont</option> <option value="VA">Virginia</option> <option value="WA">Washington</option> <option value="WV">West Virginia</option> <option value="WI">Wisconsin</option> <option value="WY">Wyoming</option> </select> </div> <div class="error hidden"> Please select an option above </div> <script type="text/javascript"> if (document.readyState === "loading") { // Calls the function during the 'DOMContentLoaded' event, after the HTML document has been completely loaded document.addEventListener("DOMContentLoaded", function () { if (window.FormTools == null) return; FormTools.selectRefresh("#dropdownComponent-cvcvgjv2snr"); }); } else if(window.FormTools != null) { // Calls the function directly in cases where the widget is rendered dynamically after 'DOMContentLoaded' has occurred FormTools.selectRefresh("#dropdownComponent-cvcvgjv2snr"); } </script> <div class="field-validation-valid" data-valmsg-for="form-BetterBreathersClubNoLocalClubAvailable-8439.State.Value" data-valmsg-replace="true"></div><div class="field-validation-valid" data-valmsg-for="form-BetterBreathersClubNoLocalClubAvailable-8439.State" data-valmsg-replace="true"></div> </div> </div> </div> <div class="col-12 col-sm-4"> <div class="form-field"> <label class="control-label required required-field-red-star" for="form-BetterBreathersClubNoLocalClubAvailable-8439_Zipcode_Value">Zip Code</label> <div class="editing-form-control-nested-control"> <input aria-required="true" class="form-control text-input zipcode required" data-ktc-notobserved-element="" data-validate-id="textComponent-k4mwxo05w0o" id="form-BetterBreathersClubNoLocalClubAvailable-8439_Zipcode_Value" name="form-BetterBreathersClubNoLocalClubAvailable-8439.Zipcode.Value" type="text" value=""> <div class="error empty hidden"> Please complete the field above </div> <div class="error email hidden"> Please enter a valid email </div> <div class="error emailplus hidden"> Email address cannot contain '+' symbols </div> <div class="error phone hidden"> Please enter a valid phone number </div> <div class="error zipcode hidden"> Please enter your zipcode in ##### or #####-#### format </div> <script type="text/javascript"> if (document.readyState === "loading") { // Calls the function during the 'DOMContentLoaded' event, after the HTML document has been completely loaded document.addEventListener("DOMContentLoaded", function () { if (window.FormTools == null) return; FormTools.setDynamic("input[data-validate-id='textComponent-k4mwxo05w0o']"); }); } else if (window.FormTools != null) { // Calls the function directly in cases where the widget is rendered dynamically after 'DOMContentLoaded' has occurred FormTools.setDynamic("input[data-validate-id='textComponent-k4mwxo05w0o']"); } </script> <div class="field-validation-valid" data-valmsg-for="form-BetterBreathersClubNoLocalClubAvailable-8439.Zipcode.Value" data-valmsg-replace="true"></div><div class="field-validation-valid" data-valmsg-for="form-BetterBreathersClubNoLocalClubAvailable-8439.Zipcode" data-valmsg-replace="true"></div> </div> </div> </div> </div> <div class="ktc-default-section"> <div class="form-field"> <label class="control-label required required-field-red-star" for="form-BetterBreathersClubNoLocalClubAvailable-8439_DiseaseInterests_Value">What lung diseases are you most interested in learning about?</label> <div class="editing-form-control-nested-control"> <ul class="checkbox-list"> <li> <input type="checkbox" data-ktc-notobserved-element="" value="4308" class="required" name="form-BetterBreathersClubNoLocalClubAvailable-8439.DiseaseInterests.CheckboxComponents"> <label>Lung Cancer</label> </li> <li> <input type="checkbox" data-ktc-notobserved-element="" value="4307" class="required" name="form-BetterBreathersClubNoLocalClubAvailable-8439.DiseaseInterests.CheckboxComponents"> <label>Asthma</label> </li> <li> <input type="checkbox" data-ktc-notobserved-element="" value="4306" class="required" name="form-BetterBreathersClubNoLocalClubAvailable-8439.DiseaseInterests.CheckboxComponents"> <label>COPD</label> </li> <li> <input type="checkbox" data-ktc-notobserved-element="" value="4621" class="required" name="form-BetterBreathersClubNoLocalClubAvailable-8439.DiseaseInterests.CheckboxComponents"> <label>Pulmonary Fibrosis/IPF</label> </li> <li> <input type="checkbox" data-ktc-notobserved-element="" value="5061" class="required" name="form-BetterBreathersClubNoLocalClubAvailable-8439.DiseaseInterests.CheckboxComponents"> <label>COVID-19</label> </li> <li> <input type="checkbox" data-ktc-notobserved-element="" value="4309" class="required" name="form-BetterBreathersClubNoLocalClubAvailable-8439.DiseaseInterests.CheckboxComponents"> <label>Other Lung Diseases</label> </li> </ul> <div class="error empty hidden"> Please complete the field above </div> <script type="text/javascript"> if (document.readyState === "loading") { // Calls the function during the 'DOMContentLoaded' event, after the HTML document has been completely loaded document.addEventListener("DOMContentLoaded", function () { }); } else { // Calls the function directly in cases where the widget is rendered dynamically after 'DOMContentLoaded' has occurred } </script> <div class="field-validation-valid" data-valmsg-for="form-BetterBreathersClubNoLocalClubAvailable-8439.DiseaseInterests.Value" data-valmsg-replace="true"></div><div class="field-validation-valid" data-valmsg-for="form-BetterBreathersClubNoLocalClubAvailable-8439.DiseaseInterests.CheckboxComponents" data-valmsg-replace="true"></div><div class="field-validation-valid" data-valmsg-for="form-BetterBreathersClubNoLocalClubAvailable-8439.DiseaseInterests" data-valmsg-replace="true"></div> </div> </div> </div> <div class="ktc-default-section"> <div class="form-field"> <label class="control-label" for="form-BetterBreathersClubNoLocalClubAvailable-8439_OtherDisease_Value">If you are interested in other lung diseases, which lung disease are you most interested in learning about?</label> <div class="editing-form-control-nested-control"> <input class="form-control text-input " data-ktc-notobserved-element="" data-validate-id="textComponent-ngxrss03lnc" id="form-BetterBreathersClubNoLocalClubAvailable-8439_OtherDisease_Value" name="form-BetterBreathersClubNoLocalClubAvailable-8439.OtherDisease.Value" type="text" value=""> <div class="error empty hidden"> Please complete the field above </div> <div class="error email hidden"> Please enter a valid email </div> <div class="error emailplus hidden"> Email address cannot contain '+' symbols </div> <div class="error phone hidden"> Please enter a valid phone number </div> <div class="error zipcode hidden"> Please enter your zipcode in ##### or #####-#### format </div> <script type="text/javascript"> if (document.readyState === "loading") { // Calls the function during the 'DOMContentLoaded' event, after the HTML document has been completely loaded document.addEventListener("DOMContentLoaded", function () { if (window.FormTools == null) return; FormTools.setDynamic("input[data-validate-id='textComponent-ngxrss03lnc']"); }); } else if (window.FormTools != null) { // Calls the function directly in cases where the widget is rendered dynamically after 'DOMContentLoaded' has occurred FormTools.setDynamic("input[data-validate-id='textComponent-ngxrss03lnc']"); } </script> <div class="field-validation-valid" data-valmsg-for="form-BetterBreathersClubNoLocalClubAvailable-8439.OtherDisease.Value" data-valmsg-replace="true"></div><div 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##### or #####-#### format </div> <script type="text/javascript"> if (document.readyState === "loading") { // Calls the function during the 'DOMContentLoaded' event, after the HTML document has been completely loaded document.addEventListener("DOMContentLoaded", function () { if (window.FormTools == null) return; FormTools.setDynamic("input[data-validate-id='textComponent-iesw50lmdrc']"); }); } else if (window.FormTools != null) { // Calls the function directly in cases where the widget is rendered dynamically after 'DOMContentLoaded' has occurred FormTools.setDynamic("input[data-validate-id='textComponent-iesw50lmdrc']"); } </script> <div class="field-validation-valid" data-valmsg-for="form-BetterBreathersClubNoLocalClubAvailable-8439.PromoCode.Value" data-valmsg-replace="true"></div><div class="field-validation-valid" data-valmsg-for="form-BetterBreathersClubNoLocalClubAvailable-8439.PromoCode" data-valmsg-replace="true"></div> </div> </div> </div> <div class="ktc-default-section"> 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