Asthma Review

Your Information

Please use this date format: DD/MM/YYYY.
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Have you received a letter advising you to complete this review?
Please use date format DD/MM/YYYY.

Patient Status

Blood Pressure

Review

In the last month have you had difficulty sleeping due to your asthma (including cough)?
Have you had your usual asthma symptoms (e.g., cough, wheeze, chest tightness, shortness of breath) during the day?
Has your asthma interfered with your usual daily activities (e.g., school, work, housework)?