Join Adira's Sounding Board

Sounding Board Details

The Sounding Board is a great way to directly inform Adira's priorities and support for matters affecting people impacted by neurodegenerative disease without making a huge commitment.

Who should join? People living with a neurodegenerative disease and neurodegenerative disease caregivers

Expected Start Date: June 2021

What does the Sounding Board do? Members of the Sounding Board will receive information about Adira and its program and be asked to provide their opinion. Each member can choose the type of information they receive and how often they respond. Topics we ask for feedback on may include program priorities, grantmaking activities, community events, or health equity issues.

Question Title

* 1. Contact Details

Name

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. How should Adira contact you?

Phone

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* 3. What is your gender identity?

Male

Female

Genderqueer/Non-binary

Prefer not to respond

Prefer to self-describe

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* 4. What is your age?

18-24

25-34

35-44

45-54

55-64

65-74

75-84

85+

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* 5. What is your race/ ethnicity?

Hispanic/Latinx

American Indian/Alaska Native

Asian

Black or African-American

Native Hawaiian/Pacific Islander

White

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* 6. How are you impacted by neurodegenerative disease?

I'm a person living with a neurodegenerative disease

I'm a caregiver (or former caregiver) for a person with a neurodegenerative disease

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* 7. Which of the following neurodegenerative diseases are you affected by?

Alzheimer's disease or related dementias

ALS (Amyotrophic Lateral Sclerosis)

Huntington's disease

multiple sclerosis

Parkinson's disease

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* 8. How long have you been dealing with a neurodegenerative disease?

0 - 3 years

3 - 5 years

5 - 10 years

10 - 20 years

More than 20 years

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* 9. Why are you interested in joining the Sounding Board?

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* 10. Which topics do you want to receive information about to provide feedback on?

Adira's demonstration projects (ex: Network Map, Take Care Community)

Adira's grantmaking activities (what and who we fund)

Adira's community engagement efforts (ex: events, storytelling)

Adira's approach to health equity (creating fair opportunities for all people impacted by ND)

Adira's Neurodegenerative Disease (ND) Congress

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* 11. Technology can have a big impact on how people engage with their communities. Some people do not have access to certain types of devices like a laptop, desktop computer, or tablet.

This can make things like taking online surveys, joining virtual meetings, or collaborating online more difficult.

If you do not have access to one of the technology devices listed above Adira may be able to provide a device, at no cost, for up to 1 year.

Are you interested in learning more about our technology kits program?

Yes