Thank you for taking the time to review this survey. Please answer these questions by marking the appropriate box. This survey is voluntary and please be assured that your answers will be kept confidential.
If the patient is unable to answer these questions, the questionnaire can be filled out by one of the relatives or caregivers. Throughout the form, first and second-person pronouns (for example, "I', "me", "my", "you") means the person you are representing.
Certain questions may look alike but each one is different. If you are unsure regarding how to answer a certain question, please give the best answer possible or send us an email at
epilepsytwh@gmail.comPlease feel free to give additional comments/suggestions in the space provided at the end of the questionnaire.
