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asthma diary template

overview

week of ________________________

if i use a peak flow meter:

my personal best peak expiratory flow (pef) is ________

  • my pef for green zone is ___________ litres per second (80% to 100% of my personal best*).
  • my pef for yellow zone is ___________ litres per second (50% to less than 80% of my personal best*).
  • my pef for red zone is less than ________litres per second (less than 50% of my personal best*).

* 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







related information

credits

current as of: august 6, 2023

author: healthwise staff
clinical review board
all healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

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this information does not replace the advice of a doctor. healthwise, incorporated, disclaims any warranty or liability for your use of this information. your use of this information means that you agree to the terms of use and privacy policy. to learn more about healthwise, visit healthwise.org. © 1995-2022 healthwise, incorporated. healthwise, healthwise for every health decision, and the healthwise logo are trademarks of healthwise, incorporated.

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