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Asthma review (child – under 12)

Use this service to submit a routine review of your child’s asthma.

This questionnaire is for a routine review of your child’s asthma symptoms. If your child is experiencing shortness of breath at present, please follow their care plan (if they have one) or ring us on 01263 724500, or 999 immediately.

You can use this service if you:

  • are registered at the surgery
  • have been invited to do so
  • the patient is aged 11 years and younger

Before you start

We’ll ask you for:

  • your first and last name, date of birth, sex, postcode, email and phone number
  • if applicable, the details of the person you are completing the form on behalf of
Start now

You can also phone us on 01263 724500.