Doctor and phone number: _______________________
I need to measure my peak flow:
Check all that apply:
- ______ When I wake up
- ______ At breakfast
- ______ At lunchtime
- ______ In the afternoon
- ______ At dinnertime
- ______ In the evening
- ______ At bedtime
- ______ As needed, when I feel short of breath, have chest tightness, or have wheezing
For instance, your doctor may want you to measure your peak flow 2 times each day, when you wake up and before you go to sleep.