1. I have been worried about: Never Sometimes Often Always Total
a) my asthma llll lllllll l l 13
b) my asthma symptoms (cough/ wheeze/ shortness of breath/ tight chest) llll llllll lll l 14
2. Because of my asthma, I am worried about: Never Sometimes Often Always Total
a) being able to see a doctor if needed lllllll lllll l l 14
b) being able to speak to my asthma team or specialist service lllllll lllll ll 14
c) getting my asthma medication prescriptions llllllllll ll ll 14
d) accessing the pharmacy for my asthma medications llllllll lll lll 14
e) going to the hospital lll lllll lll lll 14
f) any other: (please state)
3. My asthma has been triggered by: Never Sometimes Often Always Total
a) thinking about COVID-19 llllllllll lll l 14
b) worries about school work lllllll llllll l 14
c) worries because of information heard on media outlets llllllll lll l ll 14
d) worries because of social distancing and not being able to see my friends/family lllllll lllll l l 14
e) worries about money lllllllllll ll l 14
f) worries from family disagreements llllllllllll l l 14
g) worries about nurses/carers coming to visit me at home and the risk of transmitting COVID to me llllllll lllll l 14
h) worries about nurses/carers coming to visit me at home and the risk of transmitting COVID to my family members llllllll llll l l 14
i) any other: (please state)