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Asthma Diary Template

Table of Contents


Overview

Week of ________________________

If I use a peak flow meter:

My personal best peak expiratory flow (PEF) is ________ .

* To figure out 80% of personal best peak flow, multiply your personal best by 0.80. To figure out 50% of personal best peak flow, multiply your personal best by 0.50.

If your peak flow is lower than normal, check your asthma action plan or call your doctor.

My current controller medicines are _______________________________________.

Date

AM/PM peak expiratory flow (if I use a peak flow meter)

Trigger

Symptoms

Quick-relief medicine and response

Red zone visit to doctor or hospital?

Green

Yellow

Red


       

       

       

       

       

       

Credits for Asthma Diary Template

Current as of: August 6, 2023

Author: Healthwise Staff (https://www.healthwise.org/specialpages/legal/abouthw/en)
Clinical Review Board (https://www.healthwise.org/specialpages/legal/abouthw/en)
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.


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