Asthma Action Plan


Asthma Action Plan


Patients can use this template with their doctor to help manage their asthma on a daily basis and during an attack. It also includes a list of possible asthma triggers and ways to avoid them.

This action plan is divided into color-themed zones with which the health care provider can indicate specific instructions for when the patient is doing well (green), getting worse (yellow), or needs medical assistance (red). Each section lists the following types of information:

  • Signs and symptoms to help the patient determine his or her condition
  • Space for the provider to record information on:
    • Peak flow
    • Medications to be taken
    • When to seek medical care


National Heart, Lung, and Blood Institute (U.S.)

Funding Sources:

National Institutes of Health; U.S. Department of Health and Human Services


Release Date: 2004
Review Date: 2007
Recent Summary: April 2009
Original Summary: December 2004
Last Updated: 07/27/09

QualityTool Classification

Disclaimer: The inclusion of a tool in the Innovations Exchange does not constitute or imply an endorsement by the U.S. Department of Health and Human Services, the Agency for Healthcare Research and Quality or Westat of the tool or of the submitter or developer of the tool. Read more.

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information: verify here.