|
Questions |
Responses |
1. |
Do you use your reliever medication (blue inhaler) 4 or more times a week ?
|
Yes
|
No
| 2. |
Do you cough, wheeze, or have a tight chest because of your asthma 4 or more days a week?
|
Yes
|
No
| 3. |
Is coughing, wheezing, or chest tightness waking you at night 1 or more times a week?
|
Yes
|
No
| 4. |
During the last 3 months, has your asthma restricted your physical activity?
|
Yes
|
No
| 5. |
During the last 3 months, did you miss any work or school days because of your asthma?
|
Yes
|
No
| 6. |
During the last 3 months, did you go to a walk-in clinic or emergency room, or were you hospitalized for your asthma ?
|
Yes
|
No
|
|