Skip to content

Care Services Survey 2023

Your voice counts! Everything we do at The ALS Association is targeted toward fulfilling our vision of a world without ALS. We want to gather information from everyone that is impacted by ALS, so we encourage you each to complete this survey (as a caregiver, family member, or person living with ALS).  Your answers will be kept confidential.  

Your feedback is tremendously important to ensure the ongoing needs of our ALS community are met. 

Thank you in advance for helping us improve!
1.How would you describe your connection to ALS?
2.If you participated in any of the ALS Association's programs or services, please mark your level of satisfaction with them.
Very Satisfied
Satisfied
Neutral
Unsatisfied
Very Unsatisfied
Did Not Use
Communication with Care Services Staff
Certified Centers/Clinics Associated with Chapter
Communication Loan Program
Chapter Grants/Financial Assistance
Equipment Loan Program
Transportation
Support Groups
Educational Programs/Material
Smart Home/Technology
3.If you rate any as unsatisfactory can you tell us why?
4.How long have you participated in any of  The ALS Association's programs or services
5.Which items listed would you like to see increased or added to the services provided to you and your family?
6.Are there any additional programs or services that you think would be helpful to people living with ALS and their caregivers
7.Please offer any suggestions you have for improving our EXISTING programs and services
8.Please add any final comments or feedback you would like to share
9.Optional demographic information if you ae willing to share below
10.Optional: Which race/ethnicity best describes you? (Please choose only one) 
11.If you would like a member of our care services team to contact you to discuss your comments or feedback, please include your contact information below.  Thank you