Create an Asthma Action Plan

An asthma action plan is an individualized, step-by-step document you create with your doctor that will help you understand how to best treat your asthma symptoms before they get worse. It’s a key component for anyone managing their asthma and may be included in toolkits for caregivers of both adults and children with asthma.

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How to Use Your Asthma Action Plan

Download a copy of the Asthma Action Plan template below and fill it out with your doctor. It’s easy to use and is a vital resource, so keep it handy. Consider keeping a photo of your completed form on your phone for quick access. Use this form in tandem with a peak flow meter to quickly assess if your symptoms are getting worse and determine what steps to take to keep your asthma under control.


Fill and Print Your Action Plan

How to Complete Your Asthma Action Plan

Know Your Asthma Zones

Your plan contains three different zones that correspond to the severity level of your symptoms as they change day-to-day, and the actions to take for each.

Green Zone

Your symptoms are mild or virtually non-existent. This is where you should be on a daily basis with the use of your preventative medicine.

Yellow Zone

You should be cautious and treat worsening symptoms with your designated medicines.

Red Zone

This is the danger zone and you should seek medical help right away.

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Identify Your Asthma Triggers

Your plan will help you identify your triggers, when to address them, and how to best work toward relief.

Learn More Common Triggers

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Add Your Medicines

Your plan will also include information about all of your asthma medicines, instructions on when to take them, and the proper use and dosage.

Learn About Asthma Medicines

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Evaluate Your Peak Flow Measurements

Using a peak flow meter is an effective way to keep track of your lung function. Daily measurements can be an important part of your asthma management.

Track Your Peak Flow Numbers

Input Your Emergency Contact Info

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Emergency Contact Telephone Numbers

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Your Healthcare Provider

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Your Local Hospital

Track Your Asthma Journey

Download our free mobile app, Aspire by, to create a digital and easily accessible version of your Asthma Action Plan.

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