Name: Date:

Emergency Contact: Relationship:

Cell phone: Work phone:

Health Care Provider: Phone number:

Personal Best Peak Flow:

Take these quick-relief medicines:

Medicine How much to take When and how often

Call your doctor if you have been in the Yellow Zone for more than 24 hours.

Also call your doctor if:

FOR EXTREME TROUBLE BREATHING/SHORTNESS OF BREATH GET IMMEDIATE HELP!

ASTHMA ACTION PLAN

This information is for general purposes and is not intended to replace the advice of a qualified health professional. For more information on asthma, visit www.aaaai.org. © 2011 American Academy of Allergy, Asthma & Immunology

GREEN ZONE:

Doing Well

P No coughing, wheezing, chest

tightness, or difficulty breathing

P Can work, play, exercise, perform

usual activities without symptoms

OR

P Symptoms with daily activities,

work, play, and exercise

P Nighttime awakenings with

symptoms

OR

P Peak flow ____ to ____

(50% to 80% of personal best)

RED ZONE:

Alert!

P Difficulty breathing, coughing,

wheezing not helped with

P Peak flow is less than ____

(50% of personal best)