Your Personal Asthma Action Plan
People with Asthma Should Have an Asthma Action Plan
The goal of asthma self-management is to achieve better health through controlling and preventing asthma attacks. These tools for asthma control were created following the evidence-based guidelines published by the National Institutes of Health.
Asthma Action Plans
Every person with asthma needs to have a personalized Asthma Action Plan. Find the plan that works best for your needs.
Print and Fill Forms
These plans are easy to use. Select the one that is best for you, print a copy and fill in the information requested.
- Connecticut Department of Health Asthma Action Plans in PDF and Word formats. Includes Authorization for Administration of Medicine.
- Maine Asthma Prevention and Control Program Action Management Plans in PDF and information to order NCR forms.
- Minnesota Department of Health Asthma Action Plans in PDF (Child or Adult; English or Spanish).
- National Heart, Lung, and Blood Institute Asthma Action Plans in PDF or HTML.
- Utah Department of Health Asthma Action Plan.[PDF - 151 KB]
Electronic Forms
Open these forms online and fill in all the required information before you print them out.
- Pediatric/Adult Asthma Coalition of New Jersey Asthma Action Plans in English, Spanish, or English/Spanish (links to electronic fillable forms are on the right side of page).
- University of Michigan Hospitals and Health Centers Asthma Action Plans providing a choice of three different plans by age of the person with asthma.
Computer-based interactive plan
Follow these step-by-step instructions to create a customized Asthma Action Plan.
- Minnesota Department of Health's interactive Asthma Action Plan is a computer-based program that uses information entered by the healthcare provider to create a personalized plan for each patient. The plan lists daily and rescue medications with steps to take when asthma symptoms occur.
- Page last reviewed: April 8, 2015
- Page last updated: April 8, 2015
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