The Visit Kit (Free Download)

A fifteen-minute asthma visit runs on what you bring to it. This is the system that turns a month of scattered moments into a page a clinician can act on, so you leave with a plan that got sharpened, not just reprinted. It is three stages of one pipeline, and each is built to be short on purpose, because a tracking system only helps if it is light enough that you actually keep it up.

1. Capture daily, in seconds. Pick the way you will actually keep up: the one-tap Ten-Second Log on your phone, easiest for most people, or the paper monthly log below if you would rather track by hand.
2. Review weekly, in five minutes, to catch control slipping in a quiet week instead of a loud one.
3. Summarize before the visit, on one page, so the appointment runs on data.

The phone log has one more edge, and it is a big one: it keeps piling up effortlessly for as long as you like, and every line is stamped with the time it actually happened rather than reconstructed later. The paper log you tally by hand in the review below. Both get you to the same place, so pick the one you will keep up.

The reasoning behind it is in Keeping an Asthma Journal That Actually Helps and The Visit Runs on What You Bring.

1. The monthly log (the paper option)

Prefer paper over a phone? The printable is your sheet, one per month. Fill a row a day, then tally the month at the bottom and keep the sheet. Print a fresh one each month, and over a quarter you will have three sheets that show your clinician the whole trend at a glance, instead of a single day from memory. Here are three days from one child's sheet, filled in:

Read those three rows the way a clinician would, because this is the whole reason the sheet exists. Nothing here is an emergency on any single day. But the reliever climbs 2, 4, 6. The nights go bad. The peak flow slides about fifty points. A cold arrives on the 23rd and the numbers were already leaning before it did. That shape, spread across three quiet rows, is the thing memory cannot reconstruct in an exam room, and it is exactly what turns "she's had a rough week" into a decision someone can act on.

Yours will not look like this. That is fine. The point is that a filled sheet tells a story and a remembered one does not.

What each column is for

• Reliever puffs, the single most important number. Count every puff.
• Night woke, night waking from asthma is an early, sensitive sign of slipping control.
• Symptoms 0 to 3, a quick gut score, not a medical scale, just enough to see a trend.
• Peak flow, best of three blows. Record the direction over the month, not the daily reading.
• Trigger noticed, cold, smoke, pet, cold air, exercise, stress, a bad-air day. Builds the pattern.

Track it by week (fill each week, the totals roll up to the month):

Same child, same month, rolled up:

Now do the arithmetic that the sheet is really for. Eleven reliever days across four weeks is a shade under three a week, which is over the line. Averaging more than about 2 reliever days a week (the GINA control threshold, sourced in The Rescue Inhaler Buys Time), or a run of night wakings, is a flag worth raising.

Notice what that flag is not. It is not a bad month, and no single week in it would have alarmed anyone. Week 4 is the one you would remember, and week 4 alone reads as "she caught a cold." It is the four weeks stacked together that say the reliever was already creeping before the cold ever showed up, which is a different conversation with a different answer. Fill in each week's row during the five-minute review below, and the month does this arithmetic for you.

The sheet also asks for three once-a-month notes: any oral-steroid burst (the single clearest risk marker), the peak-flow trend (which direction it moved), and the triggers that repeated.

Keep the stack. Bring the last three months to each visit, so your clinician reads a quarter of real data, not a memory.

2. The five-minute weekly review

A journal only helps if someone reads it. Pick a fixed time (Sunday night works), fill in this week's row in the grid above, then run these five questions against the past seven days.

1. How many reliever days this week?
   • 0 to 2 (outside exercise) → green, carry on.
   • 3 or more → control is slipping. Check technique, check the controller is actually being taken, and plan to raise it with the clinician.
2. Any night waking from asthma? Even one night is an early warning. Two or more → treat like a yellow week.
3. What was the peak-flow trend? (direction over the week, not any single number) Drifting down → look for the cause before it becomes a flare.
4. What triggered the rough moments? A repeating trigger is a fixable one: a pet, a smoky car, a damp room, a bad-air pattern. Pick one to address this week.
5. Is the action plan still right? New triggers, a growth spurt, a season change, or a recent flare are all reasons the plan may be out of date.

A "step up" week: if two or more answers are amber, treat it as a yellow week. Tighten adherence, pre-empt the known trigger, watch the early signs closely, and message the clinic rather than waiting for the next scheduled visit. Carry anything worth the clinician's eye onto the summary below now, while you remember it.

3. The one-page pre-visit summary

Fill it from the journal the night before the appointment, hand it over at the start, and ask the clinician to look at it with you. Lead with the numbers, not the worry.

The page holds, in this order: the oral-steroid bursts since the last visit and this year (lead with this, it is the number that moves a plan), the reliever use as days per week and canisters this year, the night wakings in a typical week, the peak-flow trend with the current number against the personal best, the days of missed school or sat-out activity, a short flare log (when, how bad, what seemed to trigger it, what it took to settle), the triggers you think you are seeing, and your three questions for today. Thirty seconds to read, and every line moves a decision.

There is also a "leave the visit with" box you fill in together before you walk out: the plan change agreed, the next review date, and whether the action plan got updated. A visit that ends with that box filled is a visit that changed something. The full walkthrough of why the page works on a clinician, with a filled-in example, is The Visit Runs on What You Bring.

Where this fits: operationalizes Keeping an Asthma Journal That Actually Helps and The Visit Runs on What You Bring. Capture is the Ten-Second Log. Part of The Asthma Toolkit.

Print it. The journal is a month per page, the review and summary are a page each.