-
Reason for referral.
-
If the diagnosis of asthma
has already been established state on what evidence -
Current therapy and inhaler
devices -
Previous strategies tried
and failed. -
Smoking status
-
Other relevant potential
aggravating factors including occupation -
Spirometry or PEF
-
CXR result if performed
-
Atopic status: IgE result or
skin tests -
Previous admissions for
asthma including details of previous life-threatening or near-fatal attack
including documentation of episodes requiring ventilation -
Previous attendance at
A&E Departments -
Information on
compliance/adherence if possible -
Information on adverse
behavioural or psychological features