<qa>  What is a significant communication disability?Patients that have established care with a non-participating provider will not be eligible to participate. Patients that have been referred to the specialist for an outpatient procedure e.g. request to perform pulmonary function testing or bronchoscopy will not be eligible. Repeat visits to the same or any other participating physician will not be eligible. Adult patients who have a significant communication disability severe speech and hearing impairment, severe dementia, or mental health condition resulting in a non-communicative patient and are considered mentally competent to provide informed written consent will not be eligible to participate. 