Asthma - Retahome Survey

Please take a few minutes to complete the survey below. The Minnesota Department of Health’s Asthma Program will use your feedback for program information and support, as well as future training offerings.

In what state do you work?

In which setting do you primarily work?

How did you learn about this MDH online training course? You may select more than one option from the following list.

Former training attendee

Co-worker/Colleague

MDH website

Conference

Minnesota Asthma Alliance member

Other…

What specific knowledge or skills did you gain from this training that will most help you in conducting home assessments?

Do you currently conduct home assessments to identify environmental triggers of asthma?

Yes

Select the services you provide. You may select more than one service from the following list.

Asthma self-management education support

Offer products (Durable Medical Equipment (DME)) such as HEPA air cleaners, bed & pillow encasements, HEPA vacuum

Other…

If your organization provides referrals to agencies that offer asthma home-based services, please provide the name(s) of the agencies, if you are able.

Would you like to schedule a technical assistance consult call with the MDH Asthma Program to support the exploration of Asthma Home-Based Services Program implementation?

Yes

Provide your name

Provide your email address

Confirm your email address

Provide your phone number

Thank you for your valuable response!

Data, Statistics, and Legislation

Diseases and Conditions

Health Care Facilities and Providers

Healthy Communities, Environments, and Workplaces

Individual and Family Health

Asthma - Retahome Survey

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