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Work-Related Asthma Survey

To better ensure that the information on this web-page is relevant to all visitors, please take a couple minutes to complete an anonymous survey. Your name and identity will not be associated with any of the answers. Thank you in advance for your time.
Please provide the following information about yourself.
1.Gender:
2.What is your age?
3.Please check the box that best describes you.
4.Are you a New York State Resident?
The next five questions are intended for adults with asthma, if you do not have asthma please skip to question #11.
5.Does your asthma get worse soon after starting work?
6.Has a doctor, nurse or other health professional ever told you that you have asthma?
7.Do you try to avoid certain activities at work because they make your asthma get worse?
8.Did your asthma begin soon after breathing something irritating at work?
9.Were you ever told by a doctor, nurse or other health professional that your asthma was related to any job you ever had?
10.Did you ever tell a doctor, nurse or other health professional that your asthma was related to any job you had?
11.How useful did you find the information and links on this web-site?
not at all useful
a little bit useful
somewhat useful
useful
very useful
12.Were you able to find the asthma information you were looking for on the web-site?
13.Please use the space below to submit any additional comments or questions.