How is your Asthma?

This field is for validation purposes and should be left unchanged.
Date of Birth  Required
During the past 4 weeks, how much of the time has your asthma kept you from getting as much done at work, school or home?  Required
During the last 4 weeks, how often have you had shortness of breath?  Required
During the last 4 weeks, how often have your asthma symptoms (wheezing, coughing, shortness of breath, chest tightness or pain) woken you up at night or earlier than usual in the morning?  Required
During the last 4 weeks, how often have you used your rescue inhaler or nebuliser medication (such as Salbutamol)?  Required
How would you rate your asthma control during the last 4 weeks?  Required
How many exacerbations of your Asthma have you had in the last 12 months?  Required
Are you confident with your inhaler technique?  Required

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