In the past 4 weeks, how much of the time did your asthma keep you from getting as much done at work, school or at home?
During the past 4 weeks, how often have you had shortness of breath?
During the past 4 weeks, how often did your asthma symptoms (wheezing, coughing, shortness of breath, chest tightness or pain) wake you up at night or earlier than usual in the morning?
During the past 4 weeks, how often have you used your blue puffer or reliever medication (such as Ventolin, Asmol, Airomir, Apo-Salbutamol or Bricanyl)?
How would you rate your asthma control during the past 4 weeks?