Asthma Impairment and Risk Questionnaire (AIRQ®) Calculator

1. Bothered you during the day on more than 4 days (In the past 2 weeks)? *

2. Woke you up from sleep more than 1 time (In the past 2 weeks)? *

3. Limited the activities you want to do every day (In the past 2 weeks)? *

4. Caused you to use your rescue inhaler or nebulizer every day(In the past 2 weeks)? *

5. Did you have to limit your social activities (such as visiting with friends/relatives or playing with pets/children) because of your asthma (In the past 2 weeks)? *

6. Did coughing, wheezing, shortness of breath, or chest tightness limit your ability to exercise (In the past 2 weeks)? *

7. Did you feel that it was difficult to control your asthma (In the past 2 weeks)? *

8. Caused you to take steroid pills or shots, such as prednisone or Medrol (In the past 12 months)? *

9. Caused you to go to the emergency room or have unplanned visits to a health care provider (In the past 12 months)? *

10. Caused you to stay in the hospital overnight (In the past 12 months)? *