FTD Clinician Toolkit Resource and Engagement Survey

Cure MAPT FTD has developed a Frontotemporal Dementia (FTD) toolkit to increase awareness of FTD and support frontline healthcare professionals in recognizing and responding to the condition.

The first iteration of this pilot program focuses on outreach to healthcare professionals in Florida and Georgia, but the toolkit is available to all frontline health professionals and members of the general public.

By completing this brief, 2-minute survey before downloading the resources, you will help us better understand who is accessing the toolkit and what clinicians need to support their practice, informing how we continue to improve and expand the program's impact.

Your name, email address, and individual responses will never be shared with or sold to third parties. Survey results will be reported only in aggregate and will not identify you or your practice. Your email address will be used only to provide access to the toolkit and, if you agree, to contact you about a brief follow-up survey.

By submitting this form, you acknowledge and agree to these terms.

If you have any questions, please contact hello@curemaptftd.org.

Section 1: About You

Please enter your name.

Please enter your email address.

Please enter the name of the institution or organization you are affiliated with.

What is your profession?

What is your specialty?

In which U.S. state do you practice?

Florida

Georgia

Other U.S. state

Outside the U.S.

What is the zip code of the area in which you practice?

Section 2: About Your Practice

In the past 12 months, approximately how many patients under 65 have you seen with unexplained changes in personality, behavior, language or movement?

Do you currently have patients diagnosed with Frontotemporal Dementia (FTD) or a related form of dementia under your care?

Yes

Not sure

If you suspected FTD in a patient today, where would you refer them? (select all that apply)

Which clinic or practice would you refer to?

Is there a neurologist or memory clinic who evaluates dementia you can refer to the patient to within a reasonable distance?

Yes

Not sure

Section 3: About Your Current Knowledge

How would you rate your current knowledge of the following?

1 = None, 2 = Limited, 3 = Moderate, 4 = Good, 5 = Expert

Recognizing early signs of FTD (behavior, personality, language, movement).

Telling FTD apart from psychiatric conditions and other dementias, such as Alzheimer's disease.

Knowing where to refer a patient with suspected FTD in your area.

Recognizing a family history that may point to genetic FTD, and when to refer for genetic counseling.

Section 4: About Our Toolkit

How did you hear about this toolkit?

May we contact you later with a short follow-up survey to get your feedback on the effectiveness of the materials?

Yes