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A.S.M.A. (ASTHMA Self-management Action) Plan8/19/2017 A.S.M.A. plan for Doctors name Date Doctors phone number After hours Hospital/emergency room phone number GREEN ZONE: DOING WELL TAKE THESE LONGTERMCONTROL
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How to fill out asthma self-management action plan

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To fill out an asthma self-management action plan, follow these steps:
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- Start by downloading a blank asthma self-management action plan template.
03
- Fill in your personal information, including your name, age, and contact information.
04
- Next, provide your healthcare provider's name, phone number, and emergency contact information.
05
- Under the 'Personal Best Peak Flow' section, record your highest peak flow measurement.
06
- In the 'Green Zone' section, list your daily medication(s) and dosage(s) for when your asthma is under control.
07
- In the 'Yellow Zone' section, include instructions for when your asthma symptoms worsen, such as adjusting medication dosage or implementing additional measures.
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- Finally, in the 'Red Zone' section, outline the steps to take during an asthma emergency, including when to seek immediate medical attention.
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Keep your asthma self-management action plan in a safe and easily accessible place, such as your wallet or purse, so you can refer to it whenever needed.

Who needs asthma self-management action plan?

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Anyone diagnosed with asthma can benefit from having an asthma self-management action plan. This includes both children and adults of any age with asthma. The plan helps individuals better understand their condition, recognize early signs of worsening symptoms, and take appropriate actions to prevent complications or emergencies. It is particularly important for individuals with frequent or severe asthma symptoms, those who require daily medication, or those with a history of asthma attacks.
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An asthma self-management action plan is a personalized plan created with healthcare providers to help individuals manage their asthma on a day-to-day basis.
Individuals with asthma, especially those with moderate to severe asthma, are required to have and follow an asthma self-management action plan.
To fill out an asthma self-management action plan, individuals should work with their healthcare provider to outline daily asthma management strategies, recognize asthma triggers, and know when to seek medical help.
The purpose of an asthma self-management action plan is to empower individuals with asthma to effectively manage their condition, recognize worsening symptoms, and seek appropriate treatment.
An asthma self-management action plan typically includes information on daily medications, asthma triggers, peak flow readings, symptoms to watch for, and steps to take during an asthma attack.
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