This form will provide a score that will help your nurse practitioner determine if your child’s asthma treatment plan is working or if it might be time for a change.
Let your child respond to the first four questions (1 to 4). If your child needs help understanding the question, you may help, but let your child select the response. Complete the remaining three questions (5 to 7) on our own and without letting your child’s responses influence your answers. There are no right or wrong answers.