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♀ Patient - Asthma Treatment

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Which of the following Asthma medications would you like to request?? *

For how long have you been diagnosed as having asthma? *

Do you feel confident that your asthma is properly controlled on this medication? *

When do you generally experience symptoms of an asthma attack? *

Are you Male or Female? *

Did you ever receive a course of oral steroids as a result of your asthma? *

Did you ever have to go to the Emergency Department or were you ever admitted into hospital in relation to your asthma? *

At what time did you last talk about your asthma medication with your GP? *