CBC Asthma Control Test ages 12 and older

  • Asthma Control Test Ages 12 and older

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
  • 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.

  • Have your child answer the following questions that best applies to their asthma symptoms:

  • Calculated – do not edit
  • If your child’s score is 19 or less, it may be a sign that your child’s asthma is not controlled as well as it could be. Your nurse practitioner will discuss these results with you and your child.