Survey

Thanks For Helping
Us Help You!

Before you leave our website, would you please answer six short questions? Your answers are anonymous, and will help us learn more about how asthma affects people like you—so we can do more to help people like you breathe easier.

I know how to control my asthma.

I know my asthma triggers.

I have the information I need to control my asthma.

I have an asthma action plan and I know how to use it.

Please make a selection

How many times have you visited the emergency department in the past three months?

Please make a selection

I’ve been hospitalized in the past three months because of my asthma.

Thanks for helping!