My Asthma Symptom Diary
Use the chart below to keep track of symptoms. (Make some copies first.) Bring your Asthma Action Plan and this symptom diary to every visit with your healthcare provider. Show your records to your provider. Also ask any question you have. You should have fewer items on your chart as your asthma control gets better.
Asthma symptom diary
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Date
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Symptoms
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Possible triggers
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Action taken
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Results
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Did symptoms make it hard for you to sleep? Yes or No?
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3/3
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Example:
Wheezing, peak flow 75%
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Cold air
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2 puffs albuterol, went inside
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Symptoms gone in 20 minutes
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No
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© 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.