Brian Anderson
banderson@csm-institute.com
954-204-5428
"Improving the Day to Day of Athletic Healthcare"
Supplies & Services Survey
This survey is aimed at what, who and how much you spend in supplies, equipment and services for your sports medicine program.  If you don't know the answer to a question or category, please just leave blank.  All information will remain confidential and your data will not be shared with vendors.  Data obtained is for informational purposes only.  Thank you in advance for your participation. 

Demographics:

​School Classification:

School (Optional):

Email Address (If you want a copy of the results): 

Supplies and Services:

Sports Medicine Supplier (Tape, Wound Care, Etc.,)

     Primary Supplier (Henry Schein, Medco, Sports Health, Etc.,):  

     Secondary Supplier:

     What percent of your budget is spent on tape and tape products (pre-warp, stretch tape, heel and lace pads, etc.,):

     Approximate Amount Spent / Year (Non-Equipment):

Equpiment Budget (Modalities, Whirlpools, Ice Machine, Etc.,): 

     How many Game Readys do you own?

     Emergency Equipment:

          AEDs:  

               Brand(s)

               Total Number of AEDs:

          Do you have O2 (Oxygen)?

          How many spine boards do you own?

          How many epi-pens do you buy each year?

          Do you have a rectal thermometer?

Weather Services / Equpment:

     What equipment / service do you use for lightning / weather?

     Approximate Annual Cost:

     How would you rate your current equpment / service?

Sickle Cell Assessment:

     How much do you spend on Sickle Cell Testing (Total)?

     Where do you get your sickle cell screeing (if providing) (student health, local hospital, Quest, etc.,)

Drug Testing:

     Company (Hospital, Local, Aegis, Drug Free Sport, Quest Diagnostic, Other):

     Amount spent on drug testing?

     Approximate # of Test / Year?

     Number of Positive Test?

    Amount spent on drug counseling?

Misc.:

Amount spent on facility / equipment maintance and repairt (ice machine, modality collaboration, whirlpools, etc.,):

Amount spent on professional development / continuing education / licensing / etc., as a department:

Total amount spent on physician contracts;

Total amount spent on massage services:

Amount spent on ancillary medicine (chiro, yoga, etc.,):

Amount spent on dental;

Amount spent on vision:

Insurance:

​     Total amont spent on secondary insurance:

     Amount spent out of pocket expenses for secondary insurance:

     Amount spent on primary insurance:

Estimated Total Sports Medicine Budget: 





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