Adult and child
Adult
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Question 1

How is your asthma today? 

Question 2

How much of a problem is your asthma when you run, exercise or play sports?

Question 3

Do you cough because of your asthma?

Question 4

Do you wake up during the night because of your asthma?

Question 5

During the last 4 weeks, how many days did your child have any daytime asthma symptoms?

Question 6

During the last 4 weeks, how many days did your child wheeze during the day because of asthma?

Question 7

During the last 4 weeks, how many days did your child wake up during the night because of asthma?

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PART 2

Adult

Please complete the following questions on your own.

Adult No Children

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