Asthma Peak Flow Diary

If you have been advised by the surgery to submit your Asthma peak flow diary on a regular basis please use this form.

How to use your peak flow meter

  • Put the pointer back to the first line on the scale – this is usually 60
  • Stand, or sit upright (choose what’s easiest for you and always do it that way)
  • Take a deep breath
  • Make sure your mouth makes a tight seal around the mouthpiece
  • Blow as hard and fast as you can into the meter
  • Write down your score (the number next to the pointer)
  • Do this 3 times in a row so you get 3 scores – and use the highest of these scores to fill in your diary
Asthma Peak Flow Diary

Asthma Peak Flow Diary

Please use this date format: DD/MM/YYYY.
Any responses we send will go to this email address.

Week 1

Day 1
Symptoms
Day 2
Symptoms
Day 3
Symptoms
Day 4
Symptoms
Day 5
Symptoms
Day 6
Symptoms
Day 7
Symptoms

Week 2

Day 1
Symptoms
Day 2
Symptoms
Day 3
Symptoms
Day 4
Symptoms
Day 5
Symptoms
Day 6
Symptoms
Day 7
Symptoms
*