Allergy and Asthma Self Assessment Questionnaires 1
The following questionnaire helps us determine if an asthma sufferer is in control of his or her disease. The questions, to be answered with a “Yes” or “No”are:
- Have you visited your doctor one or more times in the past six months because of your asthma?
Yes No - Have you visited a hospital emergency room one or more times in the past six months because of your asthma?
Yes No - Have you missed one or more days of school or work in the past year because of your asthma?
Yes No - Have you been awakened one or more times in the past month by coughing or wheezing?
Yes No - Has your asthma prevented you from participating in particular exercises or sports?
Yes No - Do you use more than one canister of your choinhaler each month?
Yes No - Do you use your bronchodilator more than three or four times each month?
Yes No - Do you sometimes forget to take your prescribed asthma medication?
Yes No - Do you sometimes choose not to take your prescribed asthma medication?
Yes No - Would you like more information on how to use your inhaler properly?
Yes No
For more information on how to treat bronchial asthma and protect your loved ones to suffer bronchial asthma again. Please go to The Asthma Relief Report.
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