My Peak Flow Chart

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My Peak Flow Chart
My Name: ___________________________
My Controller Medicine: _____________________
My Personal Best Peak Flow Number is __________
Dose: _____________________________________
My
Green Zone
is above __________
My Fast-Acting Medicine: ____________________
My
Yellow Zone
is between _______ and _________
Dose: _____________________________________
My
Red Zone
is below __________
Peak Flow
Date
Date
Date
Date
Date
Date
Date
Date
Date
Date
Date
Date
Date
Date
Measurements
700
650
600
550
500
450
400
350
300
250
200
150
100
50
My Peak Flow
Number
Asthma
Symptoms
Experienced
Trigger (i.e.,
pet, exercise,
illness, smoke)?
Fast-Acting
Medicine Used?
(Yes or No)
Most peak flow meters come with sample peak flow graphs. It is a good idea to make copies.
If you no longer have a sample, you can make your own, or use the one above.
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