Thank you for completing this important asthma symptom review.  If you feel that you are struggling with your asthma in any way, or need advice then please book an appointment to discuss your asthma control with our asthma nurse.  

Did you know that you're four times less likely to have to go to hospital with an asthma attack if you use a written asthma action plan?  If you haven't got one, download an asthma action plan now and make an appointment with the asthma nurse so you can fill it in together. 

Asthma Symptom Review

Your details:

In the last month...

Has your asthma affected your sleep?
Have you had your usual asthma symptoms during the day (cough, wheeze, chest tightness or breathlessness)?
Has your asthma interfered with your usual activities (e.g. housework, work/school etc)?
During the last 4 weeks, how often have you used your rescue inhaler or nebuliser medication (such as Salbutamol)?
How would you rate your asthma control over the last 4 weeks?
Your smoking status:

For obvious health reasons we encourage all smokers to stop.  If you need help with this, then please contact the Stop Smoking Service, details of which are here

Thank you for completing your asthma review. 

We will be in touch if your asthma treatment needs to be adjusted, or if a further assessment is needed. 

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