My Asthma Symptom Diary
Keep track of symptoms with the chart below. (Make some copies first.) Show your records to your healthcare provider at your visits. As your asthma control gets better you should have fewer episodes of symptoms to record.
Asthma symptom diary
|
Date
|
Symptoms
|
Possible triggers
|
Action taken
|
Results
|
Did symptoms interfere with your sleep? Yes or No?
|
|
3/3
|
Example:
Wheezing, peak flow 75%
|
Cold air
|
2 puffs albuterol, went inside
|
Symptoms gone in 20 min.
|
No
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
© 2000-2021 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.