Asthma Pre-review

This form is to be used as a pre-check for your routine asthma review, to decide if you need further assessment. If you feel that you need urgent medical attention for your asthma or need medication urgently, please submit the form and contact the surgery in the normal way. If you need urgent medical attention when the surgery is closed, please ring 111.

For patients aged under 12, please contact the surgery for a review appointment.

About You

Please use this date format: DD/MM/YYYY.
Please provide at least one contact number or email address. By providing a mobile phone number and/or email address on this online form, we assume consent to reply by this method.

Your Asthma Review

Please contact LiveWell Dorset on 0800 8401 628 or visit www.livewelldorset.co.uk

Please note that the details you give will be used to update your medical records. Most people with well-controlled asthma will not need to attend the surgery. You will be contacted if you need to attend for a review with the asthma nurse.