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D e e A. H an r w e l, MS, RD, LIN Registered Dietitian / Licensed Nutritionist Office: 4233391415 Fax: 4233391715 Founding Member Adult Weight Management Practice GroupDietetics in Developmental
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Start by providing your personal information: Begin filling out the form by entering your full name, date of birth, gender, and contact information. This will help identify you as the person filling out the form.
02
Specify your medical history: Provide details about your medical history, including any pre-existing conditions or allergies that may be relevant to your cough. This information will help healthcare professionals better understand your overall health.
03
Describe your symptoms: In this section, explain the nature of your cough. Include details such as its duration, frequency, intensity, and any associated symptoms like fever, sore throat, or difficulty breathing. This will help healthcare providers evaluate your condition.
04
Mention any potential triggers or patterns: If you have noticed specific triggers or patterns relating to your cough, such as exposure to certain environments or activities, make sure to mention them. This information can assist in identifying possible causes of your cough.
05
Provide a timeline: Try to provide an approximate timeline of when your cough began and any changes or progression in its severity. Mention if the cough is persistent or intermittent. This helps healthcare professionals assess the chronicity of your cough.
06
Include additional relevant information: If there are any other factors or circumstances that you believe are important in understanding your cough, make sure to provide those details. For example, if you recently traveled to a different climate or were exposed to someone with a respiratory illness, mention it.

Who needs why do I cough?

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Individuals experiencing persistent cough: If you have been coughing consistently for an extended period, understanding the possible causes of your cough is crucial. Filling out the form can provide healthcare professionals with the necessary information to aid in diagnosing and treating your condition.
02
Those with associated symptoms: If your cough is accompanied by other symptoms such as fever, sore throat, chest pain, or difficulty breathing, it is essential to communicate this through the form. These additional symptoms can help in determining the underlying cause of your cough.
03
People with a history of respiratory conditions: If you have a history of respiratory conditions such as asthma, chronic obstructive pulmonary disease (COPD), or allergies, filling out the form can help healthcare providers evaluate how your current cough may be related to these conditions.
Remember, filling out the form accurately and providing as much relevant information as possible will assist healthcare professionals in diagnosing and developing an appropriate treatment plan for your cough.
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A cough is a reflex action that helps clear your airways of irritants and mucus.
Anyone experiencing a persistent or severe cough should seek medical advice from a healthcare professional.
To fill out a cough diary, document the date, time, duration, triggers, severity, and any other relevant information about your cough.
The purpose of documenting a cough is to track patterns, triggers, and severity to aid in diagnosis and treatment.
Information such as the frequency, duration, triggers, severity, and any accompanying symptoms should be reported on a cough diary.
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