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Asthma Specialists JEFFREY TULIN-SILVER, M.D. ~ SUCHETHA KINHAL, M.D. BOARD CERTIFIED ADULT & PEDIATRIC ALLERGY, ASTHMA & IMMUNOLOGY www.michiganfoodallergy.net Comprehensive Food Allergy Clinic of West Bloomfield
The American Lung Association recommends everyone 12 years of age or older with asthma take the Asthma Control Test, no matter how well controlled you think your asthma is. Your answers to this 5-question quiz will provide you a score that may help you and your doctor determine if your treatment plan is working or if it might be time for a change. Name:__________________________________ Today's Date:_______________ How To Take The Asthma Control Test 1. In the past 4 weeks, how much of the time did your asthma keep you from getting as much done at work, school or at home?
2. During the past 4 weeks, how often have you had shortness of breath?
3. 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. During the past 4 weeks, how often have you used your rescue inhaler or nebulizer medication (such as albuterol)?
5. How you would you rate your asthma control during the past 4 weeks?
What does my score mean? If you scored 19 or less, it may be an indication that your asthma is not under control. Please discuss these findings with your doctor. If you scored 20 or more, your asthma seems to be well controlled. Asthma can be unpredictable, and although your asthma symptoms seem minimal at this time, they can flare-up at any time. It is therefore important that you take the asthma control test on a regular basis. Asthma control test is a trademark of QualityMetric Incorporated. Copyright 2002, by QualityMetric Incorporated. Reprinted with permission
Michigan Allergy, Sinus & Asthma Specialists
Web: www.michiganallergy.com Web: www.michiganfoodallergy.net Email: miallergy@comcast.net Please do not email confidential medical information.
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