Use the chart below to keep track of symptoms. (Make some copies first.) Bring your Asthma Action Plan and this symptom diary to every visit with your healthcare provider. Show your records to your provider. Also ask any question you have. You should have fewer items on your chart as your asthma control gets better.
Date
Symptoms
Possible triggers
Action taken
Results
Did symptoms make it hard for you to sleep? Yes or No?
3/3
Example:
Wheezing, peak flow 75%
Cold air
2 puffs albuterol, went inside
Symptoms gone in 20 minutes
No