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ASTHMA CONTROL TEST*

The ASTHMA CONTROL TEST™* is a way to help you and your healthcare provider determine if your asthma symptoms are well controlled. Answer the 5 questions below, print out the results, and then share them with your healthcare provider. Based on your score, he or she may suggest a variety of options to help manage your asthma.

If you are 12 years or older, this short quiz will provide a score that you should share with your healthcare provider to help assess your treatment plan. The Childhood Asthma Control Test is designed for children 4 to 11 years old.

Your answers to these questions are not saved on asthma.com. Only you can have access to your answers. If you wish, you can print the test and fill it out with the help of your healthcare provider.

Score

1. 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?

2. During the past 4 weeks, how often have you had shortness of breath?

3. 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?

4. During the past 4 weeks, how often have you used your rescue inhaler or nebulizer medication (such as albuterol)?

5. How would you rate your asthma control during the past 4 weeks?

*ASTHMA CONTROL TEST is a trademark of QualityMetric Incorporated.

The Childhood Asthma Control Test was developed by GlaxoSmithKline.

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