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Asthma review (adults)

Asthma Review
Required fields are labelled

Patient Details

Please use date format: DD/MM/YYYY

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? Required
During the past 4 weeks, how often have you had shortness of breath? Required
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? Required
During the past 4 weeks, how often have you used your reliever inhaler (usually blue)? Required
How would you rate your asthma control during the past 4 weeks? Required

If you are using your blue inhaler 3 times per week or more, it can mean that your asthma is not well controlled. Therefore, please contact Orchard Surgery to book a face-to-face appointment with the asthma nurse.

If your asthma score is below 20, this could also indicate that your asthma is not well controlled, therefore please book a face-to-face appointment.

Additional Questions

Do you smoke?
Are you happy with your inhaler technique?
Do you have a written asthma care plan?
Required