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Share Your Personal Story

We are collecting stories that support our priority advocacy issues for use in legislative issue briefs, nationwide advocacy, media interviews, MS awareness and more. Please complete the survey below to share how these topics have impacted you and your family. The National MS Society may contact you for a follow-up interview and will not use your information without prior consent.
Feel free to type your responses in a text/Word document and copy, and then paste below.

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Question - Required - What is your connection to multiple sclerosis or the National MS Society? Check all that apply.

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Question - Required - What type of MS have you been diagnosed with?






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Question - Required - What is your gender?



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Question - Required - Have you ever served in the U.S. military?


 

Healthcare

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Question - Required - What health coverage do you currently have? Check all that apply.

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Question - Required - Please indicate how your healthcare costs changed (or not) in the past year. Check all that apply.

 

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Question - Required - In the past year, has your health insurance plan made changes to any benefits important to your MS care? Check all that apply.

 

 

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Question - Required - Have or could you or your loved one with MS benefit from Medicaid expansion? (If your family income is approximately $15,000 or less for 1 person, $21,000 or less for 2 people or $31,000 or less for 4 people, you might benefit.)



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Question - Required - Would you or your loved one with MS make different healthcare decisions if you knew the cost ahead of time for certain services?


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Question - Required - Do you or your loved one utilize a customized (individually configured) wheelchair, scooter or seating and positioning system paid for by Medicare?


 

Funding for MS Research

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Question - Required - Have you or loved one with MS been involved in any MS-related research?



 

  Thank you for your time. Please fill out the contact form below; we may contact you for more information.
  If you have previously registered, please login here to prepopulate your information.

If you have previously registered, please to prepopulate your information.

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Name:

 

 

   

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City/State/ZIP:

 

    

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What's this?

Please enter a username and password that you can use when you return. You can use this password to update your information or receive personalized content.

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5 to 60 characters

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5 to 20 characters

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Question - Required - This is my story. I hereby authorize a representative from the National Multiple Sclerosis Society to contact me about using my story for media, advocacy, or other opportunities when it's important to show the real faces and stories of MS.

   Please leave this field empty

     

 

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