Written Asthma Action Plan
Components and Distribution

A written asthma action plan, developed jointly by the health care provider and the patient, will help the patient manage his or her asthma. There are many different asthma action plan formats. Some examples are included on this site. It is important make an Asthma Action Plan that works well for you!  

Emergency Department Asthma Discharge Instructions (F.L.A.R.E. Plan) 
A comprehensive and concise tool to help patients receive discharge instructions based on NAEPP Guidelines for asthma management.

Asthma Action/Management Plan in Spanish

Electronic Asthma Action Plan

These action plans were prepared by the University of Michigan Health System Asthma Quality Improvement Steering Committee. 

The following action plans are in pdf format, you may need to download Adobe Acrobat Reader to view them.

National Institutes of Health Asthma Action/Management Plan - for adults

Simple Asthma Action Plan

Simple Asthma Control Plan for Child

Student Asthma Action/Management Plan

Child Care Asthma Action/Management Plan

Asthma Action Plan with red, yellow and green zones - for children

No matter what plan you use, all Asthma Action Plans should have the following components:

• Recommended doses and frequencies of daily medications

• How to adjust medicines at home in response to particular signs, symptoms, and peak flow measurements

• Listing of the patient’s Peak Expiratory Flow (PEF) levels, including personal best PEF, and calculated PEF zones based on personal best. PEF monitoring is recommended for moderate to severe asthma only.

• Symptoms indicating the need for closer monitoring or acute care

• Emergency telephone numbers for the doctor, emergency department, rapid transportation, and family/friends for support

• A list of triggers that may cause an asthma attack.  This can help inform others and the patient of what triggers to avoid.   

A copy of a patient’s asthma action plan should be:

• Carried with the patient

• Kept in the patient’s medical chart

• Provided to the patient’s day care, school, or work site

• Provided to the patient’s coach/physical education teacher

• Provided to other contacts of the patient as needed. 

For tips on getting the most out of your asthma check-ups, click here.

Adapted from “Guide to Improving Asthma Care in Oregon.” Oregon Health Division, Portland, OR, September 2001.