Madrigalpharma
Medical Science Liaison (MSL), Medical Affairs - Texas South
Madrigalpharma, Houston, Texas, United States, 77246
Medical Science Liaison (MSL), Medical Affairs - Texas South
About Madrigal: Madrigal is a biopharmaceutical company pursuing novel therapeutics for non-alcoholic steatohepatitis (NASH), also known as metabolic dysfunction associated steatohepatitis (MASH). Our first therapy, Rezdiffra (resmetirom), was granted accelerated approval by the U.S. Food and Drug Administration (FDA) for the treatment of adults with NASH with moderate to advanced liver fibrosis (consistent with stages F2 to F3 fibrosis) and is being studied in a Phase 3 trial for the treatment of NASH with compensated cirrhosis.
Opportunity and Summary of Position: Medical Science Liaison (MSL), Medical Affairs Field-Based Medical role reporting to a regional Field Director. The Madrigal MSL will build scientific partnerships with Healthcare Professionals and decision makers using evidence-based science and non-promotional scientific exchange. The MSL will serve as a point of contact for the latest scientific and clinical information regarding Madrigal’s novel NASH research program to thought leaders, academic centers, community group practices and regional professional organizations.
MSL will report external insights to better understand MASH diagnosis and treatment landscape. Strategically support the development and utilization of disease state educational materials in the field as needed through disease education, scientific collaboration, clinical trial support, and scientific exchange.
Compliant with applicable policies, procedures, and regulations. Strong understanding of US regulations and compliance.
Position Responsibilities: Establish Madrigal as a leader in MASH and chronic liver disease. Identify, develop and maintain long-term collaborative relationships with thought leaders (TL), key decision makers, investigators and other key stakeholders in the assigned therapy area and geography. Maintain clinical, scientific and technical expertise in MASH. Present data and conduct balanced peer-to-peer scientific exchange on MASH disease and Madrigal products with TLs, other HCPs, academic institutions, clinical investigators, and other stakeholders that areconsistent with Madrigal policies and procedures. Collaborate on the development and implementation of the scientific communication plan, medical-to-medical materials, and research including facilitation of research collaborations such as investigator-initiated trials and collaboration with Clinical Development colleagues on investigator selection, relationship, and site performance/recruitment. Assist in the scientific training for Commercial and other internal colleagues regarding products and the conditions they treat utilizing approved materials. Provide scientific expertise and support for speaker training and advisory boards as requested. Represent Madrigal at both national and regional medical meetings to drive awareness of Madrigal, support Medical Information booth activities as needed, cultivate relationships and scientific exchange, and gain real-world insight from HCPs on data and disease area to share with internal colleagues and help inform strategy and plans. Respond to unsolicited requests for medical information while adhering to all policies and procedures regarding the provision of medical information and documentation of requests. Compliant with applicable policies, procedures, and regulations. Strong understanding of US regulations and compliance. Travel requirements for this role are expected to be approximately 70% or greater. In-person interactions are valued as a way to build strong relationships, conduct in-depth analysis and provide on-site support. This role will require at least 65% of interactions with healthcare providers to be in-person. About Madrigal: Madrigal is a biopharmaceutical company pursuing novel therapeutics for non-alcoholic steatohepatitis (NASH), also known as metabolic dysfunction associated steatohepatitis (MASH). Our first therapy, Rezdiffra (resmetirom), was granted accelerated approval by the U.S. Food and Drug Administration (FDA) for the treatment of adults with NASH with moderate to advanced liver fibrosis (consistent with stages F2 to F3 fibrosis) and is being studied in a Phase 3 trial for the treatment of NASH with compensated cirrhosis.
Opportunity and Summary of Position: Medical Science Liaison (MSL), Medical Affairs Field-Based Medical role reporting to a regional Field Director. The Madrigal MSL will build scientific partnerships with Healthcare Professionals and decision makers using evidence-based science and non-promotional scientific exchange. The MSL will serve as a point of contact for the latest scientific and clinical information regarding Madrigal’s novel NASH research program to thought leaders, academic centers, community group practices and regional professional organizations.
MSL will report external insights to better understand MASH diagnosis and treatment landscape. Strategically support the development and utilization of disease state educational materials in the field as needed through disease education, scientific collaboration, clinical trial support, and scientific exchange.
Compliant with applicable policies, procedures, and regulations. Strong understanding of US regulations and compliance.
Position Responsibilities: Establish Madrigal as a leader in MASH and chronic liver disease. Identify, develop and maintain long-term collaborative relationships with thought leaders (TL), key decision makers, investigators and other key stakeholders in the assigned therapy area and geography. Maintain clinical, scientific and technical expertise in MASH. Present data and conduct balanced peer-to-peer scientific exchange on MASH disease and Madrigal products with TLs, other HCPs, academic institutions, clinical investigators, and other stakeholders that areconsistent with Madrigal policies and procedures. Collaborate on the development and implementation of the scientific communication plan, medical-to-medical materials, and research including facilitation of research collaborations such as investigator-initiated trials and collaboration with Clinical Development colleagues on investigator selection, relationship, and site performance/recruitment. Assist in the scientific training for Commercial and other internal colleagues regarding products and the conditions they treat utilizing approved materials. Provide scientific expertise and support for speaker training and advisory boards as requested. Represent Madrigal at both national and regional medical meetings to drive awareness of Madrigal, support Medical Information booth activities as needed, cultivate relationships and scientific exchange, and gain real-world insight from HCPs on data and disease area to share with internal colleagues and help inform strategy and plans. Respond to unsolicited requests for medical information while adhering to all policies and procedures regarding the provision of medical information and documentation of requests. Compliant with applicable policies, procedures, and regulations. Strong understanding of US regulations and compliance. Travel requirements for this role are expected to be approximately 70% or greater. In-person interactions are valued as a way to build strong relationships, conduct in-depth analysis and provide on-site support. This role will require at least 65% of interactions with healthcare providers to be in-person. Qualifications and Skills:
Advanced degree in healthcare or science-related area of study (e.g., MD/DO, PharmD, PhD, DNP, PA-C) or other life sciences or equivalent with solid medical/technical background. At least 2 years of relevant postdoctoral, academic, government or pharma industry experience, preferable in a field medical role. Ability to deeply understand and convey emergent scientific information. Knowledge of clinical medicine, disease management, and medical research, preferably in hepatic or GI disease. Working knowledge of the US Healthcare System, including care delivery, healthcare payments and Working knowledge of relevant research procedures as well as FDA and other ethical guidelines relevant to the pharmaceutical industry. Working knowledge of the rules and regulations dictating the medical affairs and research activities of life sciences companies in the US. Demonstrable multitasking, project management, and execution skills. Good interpersonal skills, including communication, presentation, persuasion, and influence. Good organizational skills, including efficiency, punctuality, and collaboration in a team environment. Proficiency with technology – computers, video conferencing, key software (e.g., Microsoft Office, CRM tools). Compensation: The expected annual base salary range for this role is between $160,000 - $220,000. Base salary is determined by several factors that include, but are not limited to, a successful candidate’s qualifications, skills, education, and experience as well as business needs and market demands. This role may also be eligible for bonus, equity, and comprehensive benefits, which include flexible paid time off (PTO), medical, dental, vision, and life and disability insurances. Madrigal is an Equal Opportunity Employer. All employment is decided on the basis of qualifications, merit, and business need. Applicants will receive consideration for employment without regard to race, ethnicity, color, religion, sex gender identity, sexual orientation, national origin, age, disability, protected veteran or disabled status, or other characteristic protected by applicable federal, state, or local law. Unsolicited resumes from agencies should not be forwarded to Madrigal. Madrigal will not be responsible for any fees arising from the use of resumes through this source. Madrigal will only pay a fee to agencies if a formal agreement between Madrigal and the agency has been established. Please be aware that we are currently receiving numerous reports of individuals misrepresenting themselves as Madrigal Pharmaceuticals’ Hiring Managers, seeking to engage with job candidates through fraudulent online advertisements or job posting sites. These unauthorized individuals are using Madrigal’s name and logo in an attempt to solicit up-front fees and obtain personal information from interested job candidates. Please know that Madrigal does not conduct interviews via text or in chat rooms; conduct interviews via Skype, RingCentral or solely via telephone; charge candidates an advance fee of any kind (e.g., fees for purchasing equipment); nor does it offer positions of employment without undergoing a thorough recruiting process. Interviews with Madrigal are conducted via the Zoom platform. Please also note that any correspondence with regard to employment would come from an authorized madrigalpharma.com email address or from an email address from one of our trusted search firm partners. We are aware that incorrect/fraudulent email addresses, with Madrigal misspelled, have been utilized in these most recent fraud attempts. If you receive unsolicited employment offers from people claiming to work for Madrigal we recommend that you: do not respond to their questions; do not open any attachments; and do not click on any hyperlinks. Do you have an advanced medical degree (master's level or higher)? * If yes, please describe your field of study. Do you have at least 2 years of relevant postdoctoral, academic, government or pharma industry experience, preferably in a field medical role? * Do you have experience working in the GI or hepatology space? If yes, please describe. * Do you currently have any conflicts of interest related to any outside interests, personal relationships, financial matters, or activities related to Madrigal? * The following questions are entirely optional. To comply with government Equal Employment Opportunity and/or Affirmative Action reporting regulations, we are requesting (but NOT requiring) that you enter this personal data. This information will not be used in connection with any employment decisions, and will be used solely as permitted by state and federal law. Your voluntary cooperation would be appreciated. Learn more . Invitation for Job Applicants to Self-Identify as a U.S. Veteran A “disabled veteran” is one of the following:
a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.
A “recently separated veteran” means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service. An “active duty wartime or campaign badge veteran” means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense. An “Armed forces service medal veteran” means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985. I IDENTIFY AS ONE OR MORE OF THE CLASSIFICATIONS OF PROTECTED VETERAN LISTED ABOVE I AM NOT A PROTECTED VETERAN I DON’T WISH TO ANSWER
Voluntary Self-Identification of Disability Voluntary Self-Identification of Disability Form CC-305 OMB Control Number 1250-0005 Expires 04/30/2026 Why are you being asked to complete this form? We are a federal contractor or subcontractor. The law requires us to provide equal employment opportunity to qualifiedpeople with disabilities. We have a goal of having at least 7% of our workers as people with disabilities. The law says wemust measure our progress towards this goal. To do this, we must ask applicants and employees if they have a disabilityor have ever had one. People can become disabled, so we need to ask this question at least every five years. Completing this form is voluntary, and we hope that you will choose to do so. Your answer is confidential. No one whomakes hiring decisions will see it. Your decision to complete the form and your answer will not harm you in any way. If youwant to learn more about the law or this form, visit the U.S. Department of Labor’s Office of Federal Contract CompliancePrograms (OFCCP) website at www.dol.gov/ofccp . How do you know if you have a disability? A disability is a condition that substantially limits one or more of your “major life activities.” If you have or have ever hadsuch a condition, you are a person with a disability.
Disabilities include, but are not limited to: Alcohol or other substance usedisorder (not currently usingdrugs illegally) Blind or low vision Cancer (past or present) Cardiovascular or heartdisease Celiac disease Cerebral palsy Deaf or serious difficultyhearing Diabetes Disfigurement, for example,disfigurement caused by burns,wounds, accidents, or congenitaldisorders Epilepsy or other seizure disorder Gastrointestinal disorders, for example,Crohn's Disease, irritable bowelsyndrome Mental health conditions, for example,depression, bipolar disorder, anxietydisorder, schizophrenia, PTSD Missing limbs or partially missing limbs Mobility impairment, benefiting from theuse of a wheelchair, scooter, walker,leg brace(s) and/or other supports Nervous system condition, for example,migraine headaches, Parkinson’sdisease, multiple sclerosis (MS) Neurodivergence, for example,attention-deficit/hyperactivity disorder(ADHD), autism spectrum disorder,dyslexia, dyspraxia, other learningdisabilities Partial or complete paralysis (anycause) Pulmonary or respiratory conditions, forexample, tuberculosis, asthma,emphysema Please check one of the boxes below: YES, I HAVE A DISABILITY, OR HAVE HAD ONE IN THE PAST NO, I DO NOT HAVE A DISABILITY AND HAVE NOT HAD ONE IN THE PAST I DO NOT WANT TO ANSWER PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.
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About Madrigal: Madrigal is a biopharmaceutical company pursuing novel therapeutics for non-alcoholic steatohepatitis (NASH), also known as metabolic dysfunction associated steatohepatitis (MASH). Our first therapy, Rezdiffra (resmetirom), was granted accelerated approval by the U.S. Food and Drug Administration (FDA) for the treatment of adults with NASH with moderate to advanced liver fibrosis (consistent with stages F2 to F3 fibrosis) and is being studied in a Phase 3 trial for the treatment of NASH with compensated cirrhosis.
Opportunity and Summary of Position: Medical Science Liaison (MSL), Medical Affairs Field-Based Medical role reporting to a regional Field Director. The Madrigal MSL will build scientific partnerships with Healthcare Professionals and decision makers using evidence-based science and non-promotional scientific exchange. The MSL will serve as a point of contact for the latest scientific and clinical information regarding Madrigal’s novel NASH research program to thought leaders, academic centers, community group practices and regional professional organizations.
MSL will report external insights to better understand MASH diagnosis and treatment landscape. Strategically support the development and utilization of disease state educational materials in the field as needed through disease education, scientific collaboration, clinical trial support, and scientific exchange.
Compliant with applicable policies, procedures, and regulations. Strong understanding of US regulations and compliance.
Position Responsibilities: Establish Madrigal as a leader in MASH and chronic liver disease. Identify, develop and maintain long-term collaborative relationships with thought leaders (TL), key decision makers, investigators and other key stakeholders in the assigned therapy area and geography. Maintain clinical, scientific and technical expertise in MASH. Present data and conduct balanced peer-to-peer scientific exchange on MASH disease and Madrigal products with TLs, other HCPs, academic institutions, clinical investigators, and other stakeholders that areconsistent with Madrigal policies and procedures. Collaborate on the development and implementation of the scientific communication plan, medical-to-medical materials, and research including facilitation of research collaborations such as investigator-initiated trials and collaboration with Clinical Development colleagues on investigator selection, relationship, and site performance/recruitment. Assist in the scientific training for Commercial and other internal colleagues regarding products and the conditions they treat utilizing approved materials. Provide scientific expertise and support for speaker training and advisory boards as requested. Represent Madrigal at both national and regional medical meetings to drive awareness of Madrigal, support Medical Information booth activities as needed, cultivate relationships and scientific exchange, and gain real-world insight from HCPs on data and disease area to share with internal colleagues and help inform strategy and plans. Respond to unsolicited requests for medical information while adhering to all policies and procedures regarding the provision of medical information and documentation of requests. Compliant with applicable policies, procedures, and regulations. Strong understanding of US regulations and compliance. Travel requirements for this role are expected to be approximately 70% or greater. In-person interactions are valued as a way to build strong relationships, conduct in-depth analysis and provide on-site support. This role will require at least 65% of interactions with healthcare providers to be in-person. About Madrigal: Madrigal is a biopharmaceutical company pursuing novel therapeutics for non-alcoholic steatohepatitis (NASH), also known as metabolic dysfunction associated steatohepatitis (MASH). Our first therapy, Rezdiffra (resmetirom), was granted accelerated approval by the U.S. Food and Drug Administration (FDA) for the treatment of adults with NASH with moderate to advanced liver fibrosis (consistent with stages F2 to F3 fibrosis) and is being studied in a Phase 3 trial for the treatment of NASH with compensated cirrhosis.
Opportunity and Summary of Position: Medical Science Liaison (MSL), Medical Affairs Field-Based Medical role reporting to a regional Field Director. The Madrigal MSL will build scientific partnerships with Healthcare Professionals and decision makers using evidence-based science and non-promotional scientific exchange. The MSL will serve as a point of contact for the latest scientific and clinical information regarding Madrigal’s novel NASH research program to thought leaders, academic centers, community group practices and regional professional organizations.
MSL will report external insights to better understand MASH diagnosis and treatment landscape. Strategically support the development and utilization of disease state educational materials in the field as needed through disease education, scientific collaboration, clinical trial support, and scientific exchange.
Compliant with applicable policies, procedures, and regulations. Strong understanding of US regulations and compliance.
Position Responsibilities: Establish Madrigal as a leader in MASH and chronic liver disease. Identify, develop and maintain long-term collaborative relationships with thought leaders (TL), key decision makers, investigators and other key stakeholders in the assigned therapy area and geography. Maintain clinical, scientific and technical expertise in MASH. Present data and conduct balanced peer-to-peer scientific exchange on MASH disease and Madrigal products with TLs, other HCPs, academic institutions, clinical investigators, and other stakeholders that areconsistent with Madrigal policies and procedures. Collaborate on the development and implementation of the scientific communication plan, medical-to-medical materials, and research including facilitation of research collaborations such as investigator-initiated trials and collaboration with Clinical Development colleagues on investigator selection, relationship, and site performance/recruitment. Assist in the scientific training for Commercial and other internal colleagues regarding products and the conditions they treat utilizing approved materials. Provide scientific expertise and support for speaker training and advisory boards as requested. Represent Madrigal at both national and regional medical meetings to drive awareness of Madrigal, support Medical Information booth activities as needed, cultivate relationships and scientific exchange, and gain real-world insight from HCPs on data and disease area to share with internal colleagues and help inform strategy and plans. Respond to unsolicited requests for medical information while adhering to all policies and procedures regarding the provision of medical information and documentation of requests. Compliant with applicable policies, procedures, and regulations. Strong understanding of US regulations and compliance. Travel requirements for this role are expected to be approximately 70% or greater. In-person interactions are valued as a way to build strong relationships, conduct in-depth analysis and provide on-site support. This role will require at least 65% of interactions with healthcare providers to be in-person. Qualifications and Skills:
Advanced degree in healthcare or science-related area of study (e.g., MD/DO, PharmD, PhD, DNP, PA-C) or other life sciences or equivalent with solid medical/technical background. At least 2 years of relevant postdoctoral, academic, government or pharma industry experience, preferable in a field medical role. Ability to deeply understand and convey emergent scientific information. Knowledge of clinical medicine, disease management, and medical research, preferably in hepatic or GI disease. Working knowledge of the US Healthcare System, including care delivery, healthcare payments and Working knowledge of relevant research procedures as well as FDA and other ethical guidelines relevant to the pharmaceutical industry. Working knowledge of the rules and regulations dictating the medical affairs and research activities of life sciences companies in the US. Demonstrable multitasking, project management, and execution skills. Good interpersonal skills, including communication, presentation, persuasion, and influence. Good organizational skills, including efficiency, punctuality, and collaboration in a team environment. Proficiency with technology – computers, video conferencing, key software (e.g., Microsoft Office, CRM tools). Compensation: The expected annual base salary range for this role is between $160,000 - $220,000. Base salary is determined by several factors that include, but are not limited to, a successful candidate’s qualifications, skills, education, and experience as well as business needs and market demands. This role may also be eligible for bonus, equity, and comprehensive benefits, which include flexible paid time off (PTO), medical, dental, vision, and life and disability insurances. Madrigal is an Equal Opportunity Employer. All employment is decided on the basis of qualifications, merit, and business need. Applicants will receive consideration for employment without regard to race, ethnicity, color, religion, sex gender identity, sexual orientation, national origin, age, disability, protected veteran or disabled status, or other characteristic protected by applicable federal, state, or local law. Unsolicited resumes from agencies should not be forwarded to Madrigal. Madrigal will not be responsible for any fees arising from the use of resumes through this source. Madrigal will only pay a fee to agencies if a formal agreement between Madrigal and the agency has been established. Please be aware that we are currently receiving numerous reports of individuals misrepresenting themselves as Madrigal Pharmaceuticals’ Hiring Managers, seeking to engage with job candidates through fraudulent online advertisements or job posting sites. These unauthorized individuals are using Madrigal’s name and logo in an attempt to solicit up-front fees and obtain personal information from interested job candidates. Please know that Madrigal does not conduct interviews via text or in chat rooms; conduct interviews via Skype, RingCentral or solely via telephone; charge candidates an advance fee of any kind (e.g., fees for purchasing equipment); nor does it offer positions of employment without undergoing a thorough recruiting process. Interviews with Madrigal are conducted via the Zoom platform. Please also note that any correspondence with regard to employment would come from an authorized madrigalpharma.com email address or from an email address from one of our trusted search firm partners. We are aware that incorrect/fraudulent email addresses, with Madrigal misspelled, have been utilized in these most recent fraud attempts. If you receive unsolicited employment offers from people claiming to work for Madrigal we recommend that you: do not respond to their questions; do not open any attachments; and do not click on any hyperlinks. Do you have an advanced medical degree (master's level or higher)? * If yes, please describe your field of study. Do you have at least 2 years of relevant postdoctoral, academic, government or pharma industry experience, preferably in a field medical role? * Do you have experience working in the GI or hepatology space? If yes, please describe. * Do you currently have any conflicts of interest related to any outside interests, personal relationships, financial matters, or activities related to Madrigal? * The following questions are entirely optional. To comply with government Equal Employment Opportunity and/or Affirmative Action reporting regulations, we are requesting (but NOT requiring) that you enter this personal data. This information will not be used in connection with any employment decisions, and will be used solely as permitted by state and federal law. Your voluntary cooperation would be appreciated. Learn more . Invitation for Job Applicants to Self-Identify as a U.S. Veteran A “disabled veteran” is one of the following:
a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.
A “recently separated veteran” means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service. An “active duty wartime or campaign badge veteran” means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense. An “Armed forces service medal veteran” means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985. I IDENTIFY AS ONE OR MORE OF THE CLASSIFICATIONS OF PROTECTED VETERAN LISTED ABOVE I AM NOT A PROTECTED VETERAN I DON’T WISH TO ANSWER
Voluntary Self-Identification of Disability Voluntary Self-Identification of Disability Form CC-305 OMB Control Number 1250-0005 Expires 04/30/2026 Why are you being asked to complete this form? We are a federal contractor or subcontractor. The law requires us to provide equal employment opportunity to qualifiedpeople with disabilities. We have a goal of having at least 7% of our workers as people with disabilities. The law says wemust measure our progress towards this goal. To do this, we must ask applicants and employees if they have a disabilityor have ever had one. People can become disabled, so we need to ask this question at least every five years. Completing this form is voluntary, and we hope that you will choose to do so. Your answer is confidential. No one whomakes hiring decisions will see it. Your decision to complete the form and your answer will not harm you in any way. If youwant to learn more about the law or this form, visit the U.S. Department of Labor’s Office of Federal Contract CompliancePrograms (OFCCP) website at www.dol.gov/ofccp . How do you know if you have a disability? A disability is a condition that substantially limits one or more of your “major life activities.” If you have or have ever hadsuch a condition, you are a person with a disability.
Disabilities include, but are not limited to: Alcohol or other substance usedisorder (not currently usingdrugs illegally) Blind or low vision Cancer (past or present) Cardiovascular or heartdisease Celiac disease Cerebral palsy Deaf or serious difficultyhearing Diabetes Disfigurement, for example,disfigurement caused by burns,wounds, accidents, or congenitaldisorders Epilepsy or other seizure disorder Gastrointestinal disorders, for example,Crohn's Disease, irritable bowelsyndrome Mental health conditions, for example,depression, bipolar disorder, anxietydisorder, schizophrenia, PTSD Missing limbs or partially missing limbs Mobility impairment, benefiting from theuse of a wheelchair, scooter, walker,leg brace(s) and/or other supports Nervous system condition, for example,migraine headaches, Parkinson’sdisease, multiple sclerosis (MS) Neurodivergence, for example,attention-deficit/hyperactivity disorder(ADHD), autism spectrum disorder,dyslexia, dyspraxia, other learningdisabilities Partial or complete paralysis (anycause) Pulmonary or respiratory conditions, forexample, tuberculosis, asthma,emphysema Please check one of the boxes below: YES, I HAVE A DISABILITY, OR HAVE HAD ONE IN THE PAST NO, I DO NOT HAVE A DISABILITY AND HAVE NOT HAD ONE IN THE PAST I DO NOT WANT TO ANSWER PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.
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