Asthma Symptom Diary
Below is a sample of what an Asthma Symptom Diary looks like.
Patient: __________________________________ Month: ________________________
| Date | Asthma Action Plan Followed: Yes or No |
Symptoms: cough, wheeze, shortness of breath |
Medicines Taken | Response: improved, need to re-medicate, or go to ER |
Possible Trigger |
|---|---|---|---|---|---|