Brian Anderson
banderson@csm-institute.com
954-204-5428
"Improving the Day to Day of Athletic Healthcare"
Asthma in Collegeiate Sports Survey
This is a survey aimed at addressing mulitple issues surrounding asthma in collegiate student athletes.  Thank you in advance for your partiicpation.

School Classification:

Number of Sports:

Number of Student Athletes:

Number of Student Athletes Diagnosed with Asthma:

Number of asthma related emergency situations in last 5 years (at your institution):

Does your medical history form inquiry about asthma status?

Do you obtain previous test results / testing for athletes that have been previously diagnosed with asthma?

For those that indicate they have a medical history of asthma or signs and symptoms consistent for asthma, do you provide them with any of the following:

     Structured warm-up?

     Education regarding medications, triggers, signs and symptoms, compliance?

     Do you perform any baseline assessments (i.e. spirometry, forced expiratory volume, etc.,)?

     Do all student-athletes with medical history or signs and sympoms consistent for asthma see a physician prior to participation in intercollegiate athletics?

How familar are you with the signs and symptoms of asthma?

Do you have access to oxygen for asthmatic emergency situations?

Do you have access to a peak flow meter for asthma and pulmary distress?

Do you obtain or store inhalers on behalf of student athletes?

​Optional Information:  If you would like a report on the results, you will need to complete the email section below:

School:

Name:

Email:





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