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Asthma Checkup Checklist

Information Your Health Care Provider Needs to Know

Enter the answers to questions below.

How well controlled has your child’s asthma been recently? Has he been having
problems? What kinds of problems?

What symptoms has your child been having and how long have the symptoms lasted?

What do you think triggers your child’s symptoms?

What medicines does your child take for his or her asthma?

When does your child take the asthma medicines?

How well do you and your child think the medicines are working? If they are not working, explain why you think this is the case?

Do the asthma medicines cause any side effects for your child? If yes, what are they?

Asthma Triggers
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Learn how controlling triggers can reduce your child’s asthma symptoms.

Asthma Action Plan
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Use this convenient form to help manage your child’s asthma.

Medicine Quiz
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Take this quiz to get answers about your child's asthma medicines.