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
  • Font Size
    • Increase Font Size
    • Decrease Font Size
    • Reset Font Size
Northfield Surgery & Field Road Surgery
Search
Show Main Menu
  • Home
  • Appointments
  • Prescriptions
  • Services
    • Asthma Review
    • Cervical Screening Questionnaire
    • Clinics & Services
    • Join the Practice
    • Online Pill Check
    • Online Services
    • Patient Letters
    • Proxy Access
    • Sick / Fit Note Request
    • Test Results
    • Travel Vaccinations
    • Update Clinical Record
    • Update your contact details
    • Urine Sample Questionnaire
    • Services Index
  • Surgery Information
    • Care Quality Commission
    • Comments Compliments & Complaints
    • Named Accountable GP
    • News
    • Opening Times
    • Our Team
    • Patient Participation Group
    • Practice Performance
    • Practice Policies
    • Training Dates
    • Surgery Information Index
  • Health Information & Support
    • COVID-19 & Flu
    • Find your NHS number
    • Health A to Z
    • Live Well
    • Medicines A to Z
    • Mental Health Awareness
    • NHS 111 Online
    • Self Care
    • Useful Links
    • Health Information & Support Index
  • Contact
    • Northfield Surgery
    • Field Road Surgery
    • The Barnby Dun Surgery
    • Facebook
    • Contact Index

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
Funeral
Services
Double
Glazing
Advertise Your
Business Here

Site

  • Sitemap
  • Back To Top

About

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

Contact

Northfield Surgery

The Vermuyden Centre, Thorne, Doncaster, DN8 4BQ

  • 01405 812121
  • syicb-doncaster.northfield-surgery-reception@nhs.net

Field Road Surgery

Field Road, Stainforth, Doncaster, DN7 5AF

  • 01302 841202
  • syicb-doncaster.fieldroadreception@nhs.net

The Barnby Dun Surgery

Stainforth Road, Barnby Dun, Doncaster, DN3 1AA

  • 01302 841202
  • syicb-doncaster.fieldroadreception@nhs.net
© Neighbourhood Direct Ltd  2025
Website supplied by Oldroyd Publishing Group

Loading...

Local Services
Funeral
Services
Double
Glazing
Advertise Your
Business Here