Asthma Screening Questionnaire for Children

YesNo
Does your child cough in their sleep more than a couple of times per month?
YesNo
Does your child cough or wheeze or get short of breath during or after exercise?
YesNo
Is your child missing school frequently because of problems like coughing or wheezing?
YesNo
If you have been told that your child has asthma, is rescue medication such as Salbutamol or Levosalbutamol being used more than two times per week for flare-ups of coughing or wheezing?
YesNo
Has your child received nebulizer treatments on more than three separate occasions in the past?
YesNo
Has your child ever vomited or thrown up after a bad bout of coughing?
YesNo
Does your child sometimes start coughing or wheezing after laughing hard or crying a lot)
YesNo