2. In the past few months, has your asthma kept you from work or school or caused you to seek urgent care at an ER, clinic or hospital?
Yes
No

3. Do you feel tight-chested, wheeze or cough during and after exercise?
Yes
No

4. Do you use your bronchodilator medicine more than three times a week? (a bronchodilator is the inhaler you use during asthma attacks to relieve symptoms)
Yes
No

5. Does your asthma keep you from doing things you would like to do?
Yes
No

6. Do you have or are you concerned about side effects from asthma medicine?
Yes
No

7. Is your asthma becoming worse as time goes on?
Yes
No

8. Are you satisfied with the way your asthma is managed?
Yes
No