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Developing an Asthma Action Plan

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Your Asthma Action Plan (Adults and Teens)

You can print out and use WebMD’s asthma action plan (at the end of this article) to record important information about your asthma. You can also use the same form for another family member with asthma, including teenagers. In this online form, you’ll have ample space to record the names and emergency phone numbers of your health care providers and asthma specialists. 

Take this asthma action plan to your asthma doctor at your next visit for help with asthma. Your doctor can fill in the specific asthma medications, dosages, and frequency.

 

An Asthma Action Plan for Your Child

You can also print out and use WebMD's asthma action plan (at the end of this article) to record important information about your child’s asthma. Fill in the names and phone numbers of your child’s health care providers. Ask your child’s doctor to fill in the instructions for all asthma medications, dosages, and frequency.

The asthma action plan outlines everything you need to do for a normal day with no asthma problems to a time of asthma emergency. Make sure your child’s teacher and any other adult caregiver has a copy of this asthma action plan.

Asthma action plans should be reviewed with your asthma doctor at least once a year. Changes in the asthma action plan may be needed because of changes in your peak flow numbers or the medications you are taking.

Always keep your asthma action plan where it can be easily found by you or your family.

Print Out Asthma Action Plan

Print out and use this asthma action plan to record important information about your asthma or a family member’s asthma (including teenagers and children).

 

Date:Person's Name / Clinic Number
Disease Severity:
Doctor:
Phone:
Nurse or Therapist:
Phone:
Evening / Weekend
Phone:

 Where you or your family member should be every day -- NO asthma symptoms. Able to do usual activities and sleep without coughing, wheezing, or difficulty breathing. 

ACTION: Control asthma. Use these medicines every day, on good days and bad days, to prevent asthma symptoms. Use a spacer with metered dose inhalers (or other asthma inhaler and/or medications prescribed for a child).

Next Article:

Which asthma symptom bothers your child the most?