Thank you for your interest in our research study, “ Assessing the Use of Mobile Technology in Adult Asthma Patients: An Observational Study”.

The purpose of this study is to understand whether the use of a smartphone-based program can help remind you to use your daily asthma controller medication. Participation in this study would last about 6 months.

To see if you might qualify for this study, I need to ask you some questions about your health history and present condition. Some of these questions may be sensitive, such as questions about your current asthma condition, what medication you are taking, how long you have been diagnosed with asthma and if applicable whether you are pregnant or planning on becoming pregnant.  You do not have to answer any questions you do not want to answer. You may stop at any time. If you do not qualify for this study, the information you provided will not be saved. 

If you would like to proceed, please click start below.
This survey takes about 5 minutes to complete.
start
 
How old are you? *

 
Do you have asthma? *


 
How long have you had asthma? *


 
Thank you for your interest in our clinical trial.  Unfortunately, from the information you have provided, you do not qualify to be a candidate at this time.  

May we contact you for future studies?


 
Do you have a smartphone? *


 
Thank you for your interest in our clinical trial.  Unfortunately, from the information you have provided, you do not qualify to be a candidate at this time.  

May we contact you for future studies?


 
What kind of smartphone do you have? *


 
What OS (operating system) does your Android have? *




 
What iOS (operating system) does your iPhone have? *




 
Do you use a daily control medication inhaler for your asthma?


 
How long have you been using a daily control medication inhaler for your asthma? *


 
Thank you for your interest in our clinical study.  Unfortunately, from the information you have provided, you do not qualify to be a candidate at this time.  

May we contact you for future studies?


 
Do you take a rescue medication for your asthma? *


 
Are you pregnant or planning to become pregnant during the study period of 6 months? *


 
What is your primary language? *


 
Thank you for your interest in our clinical study.  Unfortunately, from the information you have provided, you do not qualify to be a candidate at this time.  

May we contact you for future studies?


 
Please enter the following personal information so we can contact you to further discuss the clinical trial.

 
What's your name? *

 
What's your phone number? *

 
Mailing address? *

 
Gender?


 
Please enter the following information so we can contact you about future clinical trials.

 
What's your name? *

 
What's your phone number? *

Thank you for your interest in Cohero Health.
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Thank you for your interest in our clinical trial.  Unfortunately, from the information you have provided, you do not qualify to be a candidate at this time.
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Thank you for completing the screening questionnaire. We will review your answers and be in touch shortly if you qualify for the study.
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