Get Figure 4 Sample Patient Self-assessment Sheet For

Filling out the FIGURE 4 SAMPLE PATIENT SELF-ASSESSMENT SHEET FOR online is a crucial step in managing your asthma effectively. This guide offers clear, step-by-step instructions to help you accurately complete the assessment, ensuring that you provide your healthcare provider with the necessary information for your care.

Follow the steps to accurately complete the self-assessment sheet.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred document editor.
2. Begin by entering your name and the date at the top of the form. Ensure this information is current and accurately reflects your details.
3. In the section titled 'Your Asthma Control', respond to the questions regarding chest tightness, cough, shortness of breath, or wheezing over the past week. Mark the number of days for each question clearly in the provided spaces.
4. Indicate whether you perform peak flow readings at home by selecting 'yes' or 'no'. If you answered 'yes', indicate whether you brought your peak flow chart to the visit.
5. Answer how many days in the past week your asthma has restricted your physical activity by marking the appropriate space.
6. Respond to questions about any asthma attacks or unscheduled doctor visits since your last appointment by selecting 'yes' or 'no' as applicable.
7. Express your opinion on how well controlled your asthma is by selecting one of the provided options: very well controlled, somewhat controlled, or not well controlled.
8. Provide the average number of puffs per day of quick-relief medication you have utilized.
9. Detail any problems you have experienced with taking your medicine or following your asthma action plan. It is important to mention these concerns to your healthcare provider.
10. Include any questions or concerns you may want to discuss with your doctor in the designated space.
11. Finally, express your satisfaction level with your asthma care by selecting one of the three options: very satisfied, somewhat satisfied, or not satisfied.
12. Once you have completed all sections thoroughly, save your changes to the document, and consider downloading, printing, or sharing the completed form as required.

Take control of your asthma care—complete the FIGURE 4 SAMPLE PATIENT SELF-ASSESSMENT SHEET FOR online today!