Peak Performance USA - An Asthma Management Program for Schools

School Application

Before completing this application, you should consider contacting 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 you and your students. 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 you identify a respiratory therapist to work with, they can complete all of the required registration applications on your behalf. This will greatly streamline the entire process and get the program on-line much faster.

School Information

School District Name

School Name

City

State

Zip

School Nurse/Administrator Information

Name

Email

Telephone

Address

City

State

Zip

Demographic Information

Number of children with asthma

Number of schools in district

Number of schools applying for

Names of schools

Enter the characters at right:  

Your application will be directed to a Respiratory Therapist near you.

.