| 82669-3 | How much of the time did your asthma keep you from getting as much done at work, school or at home in the past 4W:Find:4W:^Patient:Ord:ACT | required |
| 82670-1 | How often have you had shortness of breath during the past 4W:Find:4W:^Patient:Ord:ACT | required |
| 82671-9 | How often did your asthma symptoms (wheezing, coughing, shortness of breath, chest tightness or pain) wake you up at night or earlier than usual in the morning during the past 4W:Find:4W:^Patient:Ord:ACT | required |
| 82672-7 | How often have you used your rescue inhaler or nebulizer medication (such as albuterol) during the past 4W:Find:4W:^Patient:Ord:ACT | required |
| 82673-5 | How would you rate your asthma control during the past 4W:Find:4W:^Patient:Ord:ACT | required |
| 82668-5 | Total score:Score:4W:^Patient:Qn:ACT | required |
| 82674-3 | Asthma Control Test:-:4W:^Patient:-:ACT | |