Completed 0 of 6 questions.
Please specify your current age by choosing one of the following groups.
Approximately how long ago were you diagnosed with ALS?
Was your ALS diagnosis classified as Familial or Sporadic?
Place a check next to any/all of the following industries in which you worked. Please answer relative to past and/or present jobs held.
Please select all that apply.
What is your gender?
Do you have Mercury fillings in your teeth?