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Please note that your individual results for this questionnaire are not stored or shared with anyone.
 
During the past 4 weeks, how often did your asthma prevent you from getting your work done at home, office, school?
All of the time
Most of the time
Some of the time
A little of the time
None of the time
 
During the past 4 weeks, how often have you had shortness of breath?
More than once a day
Once a day
3 to 6 times a week
Once or twice a week
Not at all
 
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 or more times a week
2 to 3 nights a week
Once a week
Once or twice
Not at all
 
During the past 4 weeks, how often have you used your rescue (blue) inhaler or nebulizer medication (such as salbutamol)?
3 or more times a day
1 or 2 times a day
2 or 3 times a week
Once a week or less
Not at all
 
How would you rate your asthma control during the past 4 weeks?
Not controlled at all
Poorly controlled
Somewhat controlled
Well controlled
Completely controlled
 
  Click below to find out your score...
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