1. Have you experienced any of the following symptoms?

2. When do your symptoms begin to flare?

You have successfully completed the Asthma Symptoms Tool. Share this information with your doctor at your next asthma check-up to discuss ways to improve your asthma.

Note: If your asthma symptoms persist or get worse before your next routine visit, please contact your health care provider.

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Thank you for using the Get Smart About Asthma Symptoms Tool

Please speak with your healthcare provider before making any changes to your asthma treatment.

1. Have you experienced any of the following symptoms?

2. When do your symptoms begin to flare?

3. What triggered your symptoms?

4. Did these symptoms cause you to regularly miss out on any activities?

5. Does your coughing and/or wheezing continuously cause you to lose sleep?

6. Does anyone in your family have long-term asthma?

7. In the past month, how many asthma attacks have you had?

8. Are you currently using a daily controller medication to help manage symptoms and asthma attacks?

3. What triggered your symptoms?

4. Did these symptoms cause you to regularly miss out on any activities?

5. Does your coughing and/or wheezing continuously cause you to lose sleep?

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6. Does anyone in your family have long-term asthma?

7. In the past month, how many asthma attacks have you had?

8. Are you currently using a daily controller medication to help manage symptoms and asthma attacks?