Asthma Review Form

This form is used for your annual asthma review. Please answer the questions and submit this form to us. If your symptoms are deteriorating or you have any concerns, please make an appointment to the respiratory nurse or a Doctor as well.

If you have had any asthma symptoms or have needed to use your reliever inhaler more than twice per week, please book a nurse appointment and do not complete the online form (the online service is only for well controlled asthma patients)

AS A PRACTICE WE WILL NOT STOP YOUR INHALERS WITHOUT PRIOR DISCUSSION WITH THE PATIENT

 

Last Updated: 03/01/2024

Your Details






Asthma Review
















Asthma Control Score






Using your inhaler

For more information on how to use your inhaler please visit AsthmaUK:- https://www.asthma.org.uk/advice/inhaler-videos/

Stopping smoking

For advice on stopping smoking please visit the Help Me Quit website: www.helpmequit.wales

Consent and Further Contact



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