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Menu
Home
Appointments
Prescriptions
About Us
Contact
Bank Holidays and other dates when the surgery is closed
Contact Telephone Numbers
Signing Up For Patient Participation Group
What to do when we are closed
GP Research
GP Training
Have your Say
Compliments and Suggestions
Friends and Family Test
Patient Opinion
Patient Participation Group
Patient Survey
Reviews and Ratings
Publication of earnings
Making the most of your Practice
Practice Policies
At the Practice
Data
Patient Record
Patient Rights
Website Policies
Regulations & Governance
Teenage Friendly
Clinics & Services
Appointments, Tests & Referrals
Appointments
Referral for Further Care
See a Doctor or Healthcare Professional
Tests & Investigations
Clinics
Travel Clinic & Holiday Vaccinations
Online Services
Patient Record
Learn My Way
Register for Online Services
NHS App
Practice Services
Advocacy Service
Hepatitis B Immunisation
Housebound & Older People
Home Visits
Interpreting Service
New Medicine Service (NMS)
NHS screening
Non NHS Services – Chargeable
Order a Repeat Prescription
Electronic Prescriptions
Managing your Infection
Wasted Medications
Patient Transport Service
Register with us as a New Patient
Further Help about how to Register with a GP
Immediately Necessary Treatment
Registration Policy
Temporary Services
Texting Service
Vaccinations
Forms
Complaints Form
Repeat Prescription Request
Keep us up to Date
Change of Contact Details Form
Communication Consent Form
Register for online services on behalf of someone else (Proxy Access)
Subject Access Request (SAR)
Register as a Carer Form
Register for Online Services Form
Summary Care Record Opt-out Form
Type 1 Opt Out
Upload photos or documents
Health Review Forms
Alcohol Consumption Review Form
Blood Pressure Review Form
Mental Health Review (PHQ-9) Form
Smoking Review Form
Help & Support
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Forms
Health Review Forms
Asthma Control Test
Adult Control Test for Adult 12+ years
Adult Control Test for Adult 12+ years
Asthma Control Test – Adult
First Name
*
Last Name
*
Email
*
Date of birth
*
Please use format day/month/year e.g. 12/05/1979
Phone Number
*
Control Test Questions
During the last 4 weeks, how much of the time has your asthma kept you from getting as much done at work, school or home?
*
All of the time – 1
Most of the time – 2
Some of the time – 3
A little of the time – 4
None of the time – 5
During the last 4 weeks, how often have you had shortness of breath?
*
More than once a day – 1
Once a day – 2
3-6 times a week – 3
1-2 times a week – 4
Not at all – 5
During the last 4 weeks, how often have your asthma symptoms (wheezing, coughing, shortness of breath, chest tightness or pain) woken you up at night or earlier than usual in the morning?
*
4 or more times a week – 1
2-3 nights a week – 2
Once a week – 3
Once or twice – 4
Not at all – 5
During the last 4 weeks, how often have you used your rescue inhaler or nebuliser medication?
*
3 or more times a day – 1
1-2 times a day – 2
2-3 times a week – 3
Once a week or less – 4
Not at all – 5
How would you rate your asthma control during the last 4 weeks?
*
Not controlled – 1
Poorly controlled – 2
Somewhat controlled – 3
Well controlled – 4
Completely controlled – 5
If you are human, leave this field blank.
View Your Score
Close
Home
Appointments
Prescriptions
About Us
Contact
Bank Holidays and other dates when the surgery is closed
Contact Telephone Numbers
Signing Up For Patient Participation Group
What to do when we are closed
GP Research
GP Training
Have your Say
Compliments and Suggestions
Friends and Family Test
Patient Opinion
Patient Participation Group
Patient Survey
Reviews and Ratings
Publication of earnings
Making the most of your Practice
Practice Policies
At the Practice
Data
Patient Record
Patient Rights
Website Policies
Regulations & Governance
Teenage Friendly
Clinics & Services
Appointments, Tests & Referrals
Appointments
Referral for Further Care
See a Doctor or Healthcare Professional
Tests & Investigations
Clinics
Travel Clinic & Holiday Vaccinations
Online Services
Patient Record
Learn My Way
Register for Online Services
NHS App
Practice Services
Advocacy Service
Hepatitis B Immunisation
Housebound & Older People
Home Visits
Interpreting Service
New Medicine Service (NMS)
NHS screening
Non NHS Services – Chargeable
Order a Repeat Prescription
Electronic Prescriptions
Managing your Infection
Wasted Medications
Patient Transport Service
Register with us as a New Patient
Further Help about how to Register with a GP
Immediately Necessary Treatment
Registration Policy
Temporary Services
Texting Service
Vaccinations
Forms
Complaints Form
Repeat Prescription Request
Keep us up to Date
Change of Contact Details Form
Communication Consent Form
Register for online services on behalf of someone else (Proxy Access)
Subject Access Request (SAR)
Register as a Carer Form
Register for Online Services Form
Summary Care Record Opt-out Form
Type 1 Opt Out
Upload photos or documents
Health Review Forms
Alcohol Consumption Review Form
Blood Pressure Review Form
Mental Health Review (PHQ-9) Form
Smoking Review Form
Help & Support