Peak Performance USA - An Asthma Management Program for Schools

Student and Family Application

Before completing this application, please contact your school’s health coordinator or school nurse and tell them about Peak Performance USA. Ask them to contact the Director of the Respiratory Care Department at one of your local hospitals to identify a respiratory therapist who would be interested in working with your school. Peak Performance USA is designed and intended to be a collaborative undertaking between respiratory therapists and school personnel who work/reside in the same community. In fact, once your school and a respiratory therapist have connected, they can complete all of the required registration applications to implement the program. This will greatly streamline the entire process and get the program on-line much faster.

Your Contact Information

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City

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Email

Telephone

School Nurse/Administrator Information

Name

School District Name

School Name

Email

Telephone

Address

City

State

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Comments

Message:

Your application will be directed to a Respiratory Therapist in your area. They will contact your school and request implementation of Peak Performance USA.

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