Asthma Visits
We at Westwood-Mansfield Pediatrics have utilized the following surveys for asthma visits to help ensure that we are managing patients according to national guidelines. Additionally, the Environmental Survey helps us recognize any environmental triggers that may be contributing to your child’s asthma.
Additionally, please make sure to check the names and expiration dates of any and all medications your child is taking. If you can bring your child’s last asthma plan, this may be helpful as well.
All patients should complete the PPOC Living with Asthma Survey and the Environmental Survey.
Children older than 6 years old, should also complete (themselves not their parents!) the appropriate version of the Childhood Asthma Control Test (ACT) form:
ACT Form 4-11 Years Old (pdf 3.14M)
ACT Form 12 years and Older (pdf 360k)