My Asthma Symptom Diary
Keep track of symptoms with this chart. Show your records to your healthcare provider at your visits. As your asthma control gets better, you should have fewer episodes of symptoms to record.
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.
Asthma symptom diary
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 |