Croyard Medical Practice Asthma Annual Review

Croyard Medical Practice Asthma Annual Review

Please complete the below form so your Doctor or Nurse can ensure you are currently receiving the correct treatment.

 

  • Your Details

    Date of Birth
    For example, 15 3 1984

  • Lifestyle

    If you need assistance in calculating how many units of alcohol you drink, please follow this link to AlcoholChangeUK's online calculator

    It is very important if you have asthma to stop smoking. This will improve your asthma symptoms as well as your general health and wellbeing. If you would like help to stop smoking please follow this link to Smoke Free Highland's online page and contact details

    Do you currently smoke?
    Do you use a vape?
    How much alcohol do you drink?
    Are you up to date (to the best of your knowledge) with the following vaccines? (optional)

  • Asthma Symptoms

    For the following questions, please tell us how your asthma has been over the last 4 weeks

    Please follow this link to the Asthma Control Test questionnaire

    How often have you had asthma symptoms during the day?
    How often have you been woken overnight due to to your asthma?
    How often have you used your reliever inhaler (commonly a blue salbutamol/ventolin inhaler)?
    Has your asthma limited you in your daily activities?

  • Asthma Attacks and Exacerbations

    Please answer the following questions about your asthma over the past 12 months

    Have you needed treatment with steroid tablets?
    Have you been to A&E, seen the Out of Hours/NHS24 service or been admitted to hospital?

  • Inhalers and medicines for asthma

    Please answer these questions thinking about the last 12 months of your treatment

    For a reminder of how to best use your inhaler, please follow this link to Asthma+Lung UK's guide

    If you have a preventer inhaler, do you take this every day as prescribed?
    Do you have any side effects from your inhalers?
    Are you happy with how to use your inhaler? (please see above link)

  • Asthma Plans

    Do you have a written asthma plan?
    Do you need a new or updated copy?
    Do you know when to seek urgent help for your asthma?
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Page last reviewed: 10 September 2025
Page created: 10 September 2025