Get Blank Asthma Diary Template - Cigna - Peacehealth

The Blank Asthma Diary Template by Cigna and Peacehealth is a useful tool designed to help individuals monitor their asthma symptoms and peak flow readings. This guide will walk you through each section of the template, ensuring you complete it accurately and effectively.

Follow the steps to fill out the asthma diary template online

1. Press the ‘Get Form’ button to access the asthma diary template, opening it in your preferred online editing tool.
2. Begin by entering the week of the diary at the top of the form. This will help you keep track of your entries chronologically.
3. If you use a peak flow meter, input your personal best peak expiratory flow (PEF) in the designated field. This value is critical for understanding your asthma management.
4. Next, fill in your PEF readings for the green zone, indicating values that fall between 80% to 100% of your personal best in liters per second.
5. Following that, enter your PEF readings for the yellow zone, noting values that fall below 80% but are above 50% of your personal best.
6. Then, input your reading for the red zone, which indicates values below 50% of your personal best. This will help alert you to seek medical assistance if necessary.
7. Record your current controller medicines in the specified section. This helps maintain consistency in your asthma management.
8. For each day, document your AM/PM peak expiratory flow measurements in the provided fields, categorizing them into green, yellow, and red zones.
9. Identify and note any potential triggers that may have affected your asthma symptoms, as well as the symptoms experienced during the week.
10. Finally, specify any quick-relief medications taken and your response to these interventions. This information will aid your healthcare provider in assessing your management plan.
11. Once you have filled out all the necessary fields, be sure to download, print, or share the diary for future use, as changes cannot be saved after closing the form.

Start filling out your asthma diary template online today to keep a comprehensive record of your health.