Follow the steps to complete the form successfully.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the date at the top of the form. This establishes when the plan is created and ensures it’s kept current.
3. Fill in the name of the person for whom the Asthma Action Plan is being created. This helps personalize the document.
4. Indicate the age of the individual. This information is crucial for assessing asthma severity and appropriate management.
5. Select the asthma severity by checking the appropriate option: Intermittent, Mild Persistent, Moderate Persistent, or Severe Persistent. This helps guide treatment and management strategies.
6. In the 'Stable (Controlled)' section, note any observations such as 'No Cough or Wheeze' or 'Normal Activity.' This reflects the individual’s current condition.
7. List any symptoms at the start of occurrences in the 'Start of Symptoms' section, such as 'Cold, Cough, Mild Wheeze.' This assists in recognizing patterns.
8. Fill in the name of the healthcare provider. This allows for easy communication regarding the individual's asthma management.
9. In the 'Management (what to do)' section, document the daily medication plan and any additional medications to use if symptoms arise.
10. In the 'Worsening Symptoms' section, outline any signs that indicate a deterioration in health, such as 'Increased Difficulty Breathing.' These signals are critical for immediate action.
11. State the management steps to take in response to worsening symptoms. Specify what type of medication should be used every 20 minutes and the action to take if symptoms do not improve.
12. Remember to note the importance of following up with the healthcare provider within two days of any emergency visit.
13. Finally, consider options for saving changes, downloading, printing, or sharing the completed form as necessary for easy access and distribution.

Start filling out your Pediatric Associates Asthma Action Plan online today for better asthma management.