Annual Asthma Review Questionnaire

Are you in control of your asthma? Or is your asthma in control of you? 

As part of your annual asthma review, we would like to invite you to complete this asthma management questionnaire to provide the GP with some basic information of your asthma control.  This will highlight anything that the GP needs to address as part of your review and also gives you the opportunity to tell us about any issue that you feel you have with your asthma or would like some extra support with. If you have any problems completing the questionnaire, please speak to a receptionist who will be happy to go through it with you. 

Please read through the questions carefully and answer as honestly as you can.

Annual Asthma Review Questionnaire
If no, please detail what support you feel that you need.
This can be number of cigarettes, number of e-cigarette usage etc.
If yes, please also write if you would like us to contact you regarding this.

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This information is retained for up to 28 days.

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