Asthma Control Test
Child 4-11years old
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Asthma Control Test (Child 4-11 years old)
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This Questionnaire is to review your Asthma, and your practice may not see this report for up to 7 days. If you have severe symptoms, please contact the practice directly for urgent appointment or call 111
Step One
Important Information
- Complete the test below
- Note down the result score
Part 1 – Adult and Child
4 Questions
Step 1: Let your child respond to the first four questions (1 to 4). If your child needs help in reading or understanding the question, you may help, but let your child select the response.
Part 2 – Adult
3 Questions
Step 2: Complete the remaining three questions (5 to 7) on your own and without letting your child’s responses influence your answers. There are no right or wrong answers.
Step 3: Take a print-out of the test results to the doctor to talk about your child’s total score.
Step Two
Important Information
- Enter your score
- Complete and send the form for review
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