Get Asthma Therapy Assessment Questionnaire

The Asthma Therapy Assessment Questionnaire is an important tool designed for assessing asthma control in pediatric and adolescent patients aged 5 to 17 years. This guide will provide step-by-step instructions to help you complete the questionnaire effectively online.

Follow the steps to fill out the Asthma Therapy Assessment Questionnaire online.

1. Select the ‘Get Form’ button to access the Asthma Therapy Assessment Questionnaire and open it in your browser or preferred document editor.
2. Begin by entering the patient’s name in the designated field, followed by their ID number. You will also need to fill in the physician’s name and date.
3. Carefully review each question listed in the questionnaire. For each item, select one answer that best reflects your child’s experience over the past four weeks. Make sure to check only one response per question.
4. If applicable, indicate whether your child uses an inhaler or nebulizer for quick relief and record the frequency of use in the specified field.
5. Add the point values in the blue area corresponding to each selected answer to calculate the total score. Enter this total in the provided section.
6. If the total score is 1 or greater, it is advisable to discuss the results with your child’s physician for further guidance.
7. Once you have completed all sections and verified your answers, you may save changes, download, print, or share the form as needed.

Complete the Asthma Therapy Assessment Questionnaire online to support your child's asthma management.