Changes to how you order prescriptions

As of Monday 13th January 2025 we will no longer be accepting prescription requests over the phone. For further information please call the practice on 01506 771800.

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Asthma Control Test
Adult Control Test for Adult 12+ years

Adult Control Test for Adult 12+ years

Asthma Control Test – Adult

First Name *

Last Name *

Email *

Date of birth *

Please use format day/month/year e.g. 12/05/1979

Phone Number *

Control Test Questions

During the last 4 weeks, how much of the time has your asthma kept you from getting as much done at work, school or home? *

All of the time – 1

Most of the time – 2

Some of the time – 3

A little of the time – 4

None of the time – 5

During the last 4 weeks, how often have you had shortness of breath? *

More than once a day – 1

Once a day – 2

3-6 times a week – 3

1-2 times a week – 4

Not at all – 5

During the last 4 weeks, how often have your asthma symptoms (wheezing, coughing, shortness of breath, chest tightness or pain) woken you up at night or earlier than usual in the morning? *

4 or more times a week – 1

2-3 nights a week – 2

Once a week – 3

Once or twice – 4

Not at all – 5

During the last 4 weeks, how often have you used your rescue inhaler or nebuliser medication? *

3 or more times a day – 1

1-2 times a day – 2

2-3 times a week – 3

Once a week or less – 4

Not at all – 5

How would you rate your asthma control during the last 4 weeks? *