From Kathleen MacNaughton, R.N.,
Your Guide to Asthma.
FREE Newsletter. Sign Up Now!

About.com Health's Disease and Condition content is reviewed by Sanja Jelic, MD

Here is a tool you can use to track your asthma symptoms. You can also record and identify your asthma triggers, which are the things that set off asthma symptoms or asthma attacks.

You can use this page as a reference for the types of information you can keep track of in your own asthma diary or notebook. Or, if you prefer, print our PDF version and make copies you can write on each week.

Asthma Diary Template

Date	AM PEF	PM PEF	Triggers	Rate Symptoms*	Medicine Taken & Response
				__ Cough __ Wheeze __ Short of breath __ Tightness __ Other:
				__ Cough __ Wheeze __ Short of breath __ Tightness __ Other:
				__ Cough __ Wheeze __ Short of breath __ Tightness __ Other:
				__ Cough __ Wheeze __ Short of breath __ Tightness __ Other:
				__ Cough __ Wheeze __ Short of breath __ Tightness __ Other:
				__ Cough __ Wheeze __ Short of breath __ Tightness __ Other:
				__ Cough __ Wheeze __ Short of breath __ Tightness __ Other:

*Use this scale to rate your symptoms:
0=None; 1=Mild; 2=Moderate; 3=Severe; 4=Emergency