Child Asthma Review form

Please Ask Your Child These Questions

Please complete the following questions for your child

ASTHMA SCORE

The numbers at the beginning of each answer indicate points to work out your childs asthma score.

Please select below what your childs asthma score is, by adding the number at the beginning of the answers they have given.

Asthma Score *

15 or less = Your child's asthma has not been controlled recently. Please book an appointment for an asthma review

16-19 = Your child's asthma has not been as well controlled as it could be. Please consider booking a review appointment to see how we can help.

20-25 = Your child's asthma is on target and is well controlled.

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