Parent Consent Form

Many thanks for taking the time to read information about the Asthma&You questionnaire. This questionnaire asks your child about them, their asthma and how it affects their school life. Their answers are important to us as they will help with research into how we can help young people with asthma have a better time at school.

The questionnaire will take no longer than 20-30 minutes and will ask them about:

  • General information (e.g. age, what area they live in etc.)
  • How well their asthma is controlled
  • Use of asthma medication
  • Unplanned medical attention
  • Asthma at school
  • Smoking and parental smoking
  • Emotional and behavioural well-being

We will also ask their school for information about their attendance and sick leave. This information will be very helpful in working out whether asthma has an impact on attendance. If you would prefer us not to collect this information from the school, you can indicate this below.

All the information they give us will be kept in a secure database by our research team. All information will be kept strictly confidential and at no time will we share any of their personal details with anybody not connected to the research.

If you have any questions about the questionnaire or our research, or if you would like us to send you a paper copy of the questionnaire for them to complete, please ask one of the researchers or contact us at

Child’s first name

Child’s last name

Child’s school

Child’s date of birth

Child’s email


I declare that:

(please check all boxes that you agree with)