Prescriptions: Asthma & Medication Review

If you have been advised by the surgery to submit an annual review of your asthma symptoms please use this form. If your symptoms are significantly deteriorating or you are having any concerns please make a telephone appointment with our Nurse.

You may have received a text or a letter. This is because asthma reviews are an essential way of monitoring your symptoms and ensuring your medication is safe and appropriate. 

 Please do not write any clinical queries on this form. Any clinical queries or request for appointments via this form will be discarded. To make an appointment either book online via the NHS app/Patient access or by calling reception. We will start to process your form by the next working day but it will take up to 5 working days to complete. Please DO NOT call before 5 working days as you will not receive a status update from reception or the administrative team. If you are NOT a registered patient then your form will be discarded. This service is only for patients registered at the surgery aged 16 and over; and for parents or legal guardians of children. Forms must be completed in the UK due to GDPR regulations 
Prescriptions: Asthma & Medication Review
An exacerbation is where your symptoms got worse, your reliever did not help and you needed to seek medical attention.
An exacerbation is where your symptoms got worse AND your reliever did NOT help and you needed to seek urgent medical attention
Please note that your answer will not be seen immediately and you should direct any URGENT queries to reception.
Asthma Control Test
Medication Review
If No please write 'NO'. This is in relation to all your medication. Please state the medication and the side effect. E.g. Paracetamol: Constipation
Please note that if your mental health is currently significantly impacted and you are concerned for your well-being you must contact the crisis team on 0300 200 0011 and select option 1 or 999.
If no write: NO. If yes, please state the name and dose of these medications.

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This information is retained for up to 28 days.

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Local Services, Let
Local Services, Let