Asthma Screening Questionnaire

Does your child experience any of the following?
Chronic cough at night?
Coughing during and/or after exercise?
Tires easily or has trouble keeping up with other children of the same age?
Has colds that often progress into bronchitis?
Often clears his/her throat?
Has seasonal allergies (hay fever, eczema etc.)?
Chest tightness, wheezing and/or shortness of breath after exercise or activity?

If you answered "yes" to any of these questions, please contact your medical provider regarding asthma testing.