Asthma Symptom Diary
Below is a sample of what an Asthma Symptom Diary looks like.
Patient: __________________________________ Month: ________________________
| Date | Used Asthma Action Plan?
Yes or No |
Symptoms: (cough, wheeze, shortness of breath) |
Medicine(s) taken | Response: improved, need more medicine, or went to ER |
Possible trigger(s) |
|---|---|---|---|---|---|