Technology and Equipment Survey
The A-TEAM is currently seeking input from individuals living with ALS to get a better sense of the limitations and gaps in accessible technology and equipment. We encourage you to be as thorough as possible when answering below. The more information you provide, the more we can learn to help solve problems.

By completing the survey below, you can help us discover the state of technology today and help us identify new ways that technology and equipment can make life more productive and bring more independence to those living with ALS.
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What is your relationship to ALS? *
What type of mobility equipment is being used, if any? *
Select all the apply.
必填
If you are using a power wheelchair, how are you primarily control the power wheelchair?
清除選取的項目
Please describe any problems or issues you are having with your mobility equipment. Please include the type (make and model) of equipment if possible.
What type of alternative access methods are being used for communication, if any? *
Select all that apply.
必填
Please describe any problems or issues you are having with your alternative access methods. Please include the type (make and model) of equipment if possible.
What type of Speech-Generating Device is being used, if any? *
Select all that apply.
必填
If you are using a Speech-Generating Device, how are you accessing the device?
清除選取的項目
What type of low-tech/no tech communication system is being used, if any? *
Select all that apply.
必填
Please describe any problems or issues you are having with your low-tech/no tech communication system.
What type of home automation is being used, if any? *
Select all that apply.
必填
If you are using home automation systems, what are you using it to control?
Select all that apply.
Please describe any problems or issues you are having with your home automation. Please include the type (make and model) of equipment if possible.
What type of other equipment are you using, if any? *
Select all that apply.
必填
Please describe any problems or issues you are having with your other equipment. Please include the type (make and model) of equipment if possible.
Email Address
Please provide an email if you would like to receive a direct response and/or updates on the A-TEAM's work.
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這份表單是在 Team Gleason 中建立。 檢舉濫用情形