What would you like prioritized most related to your ALS care? (Rank all that apply)
 Symptom Management
 Access to Assistive Devices
 Quality of Life Support
 Coordination of Care
 Access to Clinical Trials and Research
 Home Care Services
 Support for my Caregiver
 Mental Health Support
 Information about VA benefits that I am entitled to for ALS (i. e.  Equipment, medication  
management, disability compensation, special adaptive housing grants)
I know where to access information about VA ALS care and benefits online.
 Strongly Disagree
 Disagree
 Neither Disagree nor Agree
 Agree
 Strongly Agree
 My VA ALS care is coordinated  
(e. g.  appointments, medications, equipment and specialty referrals).
 Strongly Disagree
 Disagree
 Neither Disagree nor Agree
 Agree
 Strongly Agree
 My ALS care is coordinated.   
(e. g.  appointments, medications, equipment and specialty referrals).
 Strongly Disagree
 Disagree
 Neither Disagree nor Agree
 Agree
 Strongly Agree
 I receive ALS support from my ALS care  
team in a reasonable amount of time.
 Strongly Disagree
 Disagree
 Neither Disagree nor Agree
 Agree
 Strongly Agree
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