ACT

Asthma Control Test (ACT)

"*" indicates required fields

1. 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?*
2. During the past 4 weeks, how often have you had shortness of breath?*
3. 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. During the past 4 weeks, how often have you used your rescue inhaler or nebulizer medication (such as albuterol)?*
5. How would you rate your asthma control during the past 4 weeks?*
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