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Symptom Checklist

If you are currently being treated for asthma, here's a quick way to find out if your asthma symptoms are under control. Just answer the questions on this checklist, print out your answers and share the results with your doctor. Together you'll be able to determine if your asthma symptoms are under control or if you need to consider other options.

Please note: This checklist is for your personal use only. No personal information you enter is collected by this Web site.

1. Over the past month, have asthma symptoms kept you from participating in activities or from getting as much done at work or at home?	Yes No
2. Over the past month, have you woken up at night or earlier than usual in the morning because of asthma symptoms (coughing, wheezing, shortness of breath, or tightness of chest)?	Yes No
3. Do you feel you need to use your rescue inhaler more and more often?	Yes No
4. Do you sometimes forget to use your maintenance inhaler (inhaled corticosteroid)?	Yes No

If you answered YES to any of these questions, your asthma symptoms may not be as controlled as they could be. Print out your answers and discuss them with your doctor. Ask if ASMANEX® could help manage your asthma symptoms.