Hamilton Medical Centre

86 Market Street, Birkenhead, Merseyside, CH41 6HB

Telephone: 0151 649 0191

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URGENT Patient Notice Closed for Staff Training Prescription Requests over the Telephone to stop from July 2023 PATCHS a new platform for online consultations going live 15th February Patient Update on NHS Services Across Wirral We are closed Monday 19th September Farewell to Dr Das and Dr Wyche Brighter Birkenhead PCN Health Fayre COVID Vaccination Clinics Thursday 10th and Friday 11th February COVID Vaccination Clinic today, Appointments available!

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Asthma Control Test

Asthma Control Test

This Asthma Control Test will provide us with a snapshot of how well your asthma has been controlled over the last four weeks.

Name*
Date of Birth*
DD slash MM slash YYYY
During the past 4 weeks, how often did your asthma prevent you from getting as much done at work, school or home?*
- All of the time
- Most of the time
- Some of the time
- A little of the time
- None of the time
During the past 4 weeks, how often have you had shortness of breath?*
- More than once a day
- Once a day
- 3-6 times a week
- 1-2 times a week
- Not at all
During the past 4 weeks, how often did your asthma symptoms (wheezing, coughing, chest tightness, shortness of breath) wake you up at night or earlier than usual in the morning?*
- 4 or more times a week
- 2-3 nights a week
- Once a week
- Once or twice
- Not at all
During the past 4 weeks, how often have you used your reliever inhaler (usually blue)?*
- 3 or more times a day
- 1-2 times a day
- 2-3 times a week
- Once a week or less
- Not at all
How would you rate your asthma control during the past 4 weeks?*
- Not controlled
- Poorly controlled
- Somewhat controlled
- Well controlled
- Completely controlled
Finally, how many exacerbations have you had in the last year?*
Email
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82472

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Advertising: Tailor information and advertising to your interests based on e.g. the content you have visited before. (Currently we do not use targeting or targeting cookies.
Advertising: Gather personally identifiable information such as name and location

This website will:

Essential: Remember your cookie permission setting
Essential: Allow session cookies
Essential: Gather information you input into a contact forms, newsletter and other forms across all pages
Essential: Keep track of what you input in a shopping cart
Essential: Authenticate that you are logged into your user account
Essential: Remember language version you selected
Functionality: Remember social media settings
Functionality: Remember selected region and country
Analytics: Keep track of your visited pages and interaction taken
Analytics: Keep track about your location and region based on your IP number
Analytics: Keep track of the time spent on each page
Analytics: Increase the data quality of the statistics functions

This website won't:

Remember your login details
Advertising: Use information for tailored advertising with third parties
Advertising: Allow you to connect to social sites
Advertising: Identify device you are using
Advertising: Gather personally identifiable information such as name and location

This website will:

Essential: Remember your cookie permission setting
Essential: Allow session cookies
Essential: Gather information you input into a contact forms, newsletter and other forms across all pages
Essential: Keep track of what you input in a shopping cart
Essential: Authenticate that you are logged into your user account
Essential: Remember language version you selected
Functionality: Remember social media settings
Functionality: Remember selected region and country
Analytics: Keep track of your visited pages and interaction taken
Analytics: Keep track about your location and region based on your IP number
Analytics: Keep track of the time spent on each page
Analytics: Increase the data quality of the statistics functions
Advertising: Use information for tailored advertising with third parties
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