Skip to main content
  • Language
    • Afrikaans
    • Albanian
    • Arabic
    • Armenian
    • Azerbaijani
    • Basque
    • Belarusian
    • Bengali
    • Bulgarian
    • Catalan
    • Chinese (Simplified)
    • Chinese (Traditional)
    • Croatian
    • Czech
    • Danish
    • Dutch
    • Esperanto
    • Estonian
    • Filipino
    • Finnish
    • French
    • Galician
    • Georgian
    • German
    • Greek
    • Gujarati
    • Haitian Creole
    • Hebrew
    • Hindi
    • Hungarian
    • Icelandic
    • Indonesian
    • Irish
    • Italian
    • Japanese
    • Kannada
    • Korean
    • Lao
    • Latin
    • Latvian
    • Lithuanian
    • Macedonian
    • Malay
    • Maltese
    • Norwegian
    • Persian
    • Polish
    • Portuguese
    • Romanian
    • Russian
    • Serbian
    • Slovak
    • Slovenian
    • Spanish
    • Swahili
    • Swedish
    • Tamil
    • Telugu
    • Thai
    • Turkish
    • Ukrainian
    • Urdu
    • Vietnamese
    • Welsh
    • Yiddish
  • 028 276 38383
  • Font Size
    • Increase Font Size
    • Decrease Font Size
    • Reset Font Size
The Frocess Medical Centre
Search
Show Main Menu
  • Home
  • Appointments
  • Prescriptions
  • Services
    • Alcohol Audit C
    • Asthma Review
    • Clinics & Services
    • Fit Notes & Sick Notes
    • Join The Surgery
    • Non-NHS Services
    • Other On-Site Services
    • Pharmacy First
    • Primary Care Multi-Disciplinary Services
    • Temporary Registration
    • Patient Health Questionnaire (PHQ-9)
    • Update Your Details
  • Practice Information
    • Complaints
    • News
    • Our Team
    • Patient Participation Group
    • Practice Area
    • Practice Leaflet
    • Practice Policies
    • Primary Care Multi-Disciplinary Team
    • Times & Out Of Hours
  • Health Information and Support
    • Antibiotics
    • Childhood Vaccinations
    • Children’s symptom checker
    • Health and Social Care
    • Health and wellbeing
    • Health services
    • Illnesses and conditions
    • Minor Ailments
  • Contact & Location

Asthma Review

Please complete this form before you attend your Asthma review.

Your Details

DD/MM/YYYY
Find my NHS Number (opens in new window)
Your Contact Details

Review Questions
Have you had difficulty sleeping because of your asthma symptoms (including cough)?
Have you had your usual asthma symptoms during the day (cough, wheeze, chest tightness or breathlessness)?
Has your asthma interfered with your usual activities (e.g. housework, work/school etc)?
If you are having any symptoms have you noticed a specific cause or causes?
Have you found anything which helps to relieve your symptoms (apart from your medication)?
Are you having any problems using your inhaler?
Do you smoke?

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key and is accessed over a secure connection by nominated staff. We have a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.


Local Services

Site

  • Sitemap
  • Back To Top

About

  • Disclaimer
  • Website Privacy
  • Website Accessibility
  • Cookies
  • Content Attribution

Contact

The Frocess Medical Centre

56 Main Street, Cloughmills, Ballymena, BT44 9LF

  • 028 276 38383
© Neighbourhood Direct Ltd  2025
Website supplied by Oldroyd Publishing Group

Loading...

Local Services