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Help us help others with epilepsy
Understanding your treatment experience helps us provide helpful information to you and others whose lives are affected by epilepsy.
*Please select from the list below all the medications you or the person you care for is currently taking.
Please answer a few brief questions to help us help you better
Please tell us a little more about your life with epilepsy and your treatment plan.
This information helps us understand our subscribers better so we can provide the
best support system—designed just for them. We respect your privacy; your
answers will be used only to help us improve the program. Please read our
1. Overall, how much of an impact does epilepsy and/or seizures
have on personal life (ie, personal relationships,
leisure, or home life)?
2. I constantly worry that I will hurt myself or others while having a seizure.
3. I actively seek out information about new ways to cope with epilepsy.
4. How concerned are you, if at all, about the possibility of having a seizure in the next 12 months?
5. How likely, if at all, do you think it is that you will
be restricted from driving in the future due to epilepsy or seizures?
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