Skip to main content

Asthma review

Asthma Review

About You

Please use this date format: DD/MM/YYYY. Your date of birth is required to verify your identity.
This email address will be used for all correspondence relating to this request. Please be aware that if anyone else has access to this email address that they may see responses sent to you.

Asthma Control Score

During the past 4 weeks, how often did your asthma prevent you from getting as much done at work, school or home?
During the past 4 weeks, how often have you had shortness of breath?
During the past 4 weeks, how often did your asthma symptoms (wheezing, coughing, chest tightness, shortness of breath) wake you up at night or earlier than usual in the morning?
During the past 4 weeks, how often have you used your reliever inhaler (usually blue)?

If you are needing to use your reliever (usually blue) inhaler more than 2-3 times a week then your asthma may not be well controlled. If so, please also make an appointment to discuss your inhalers with one of our asthma nurses.

How would you rate your asthma control during the past 4 weeks?