Submit a Clinical Review

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This field is for validation purposes and should be left unchanged.

Full Name(Required)

Date of Birth(Required)

Email(Required)

Phone Number(Required)

How many asthma exacerbations (attacked) have you had in the past year?(Required)

How many times have you attended Accident and Emergency Department since your last asthma review?(Required)

Please specify your inhaler(Required)

For further information, please see: nhs.uk/quit-smoking

Your Calculated Asthma score(Required)

Your score is less than 20.

Your asthma may not have been controlled during the past 4 weeks.

Your doctor or nurse can recommend an asthma action plan to help improve your asthma control.

Your score is between 20 and 24.

Your asthma appears to have been reasonably well controlled during the past 4 weeks.

However, if you are experiencing symptoms your doctor or nurse may be able to help you.

Your score is 25, well done!

Your asthma appears to have been under control over the last 4 weeks.

However, if you are experiencing any problems with your asthma, you should see your doctor or nurse.

I have the following information, questions or concerns that I would like to raise with my Asthma Nurse or Doctor

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