SRF Provider (Physician & Therapists) Survey
This questionnaire aims to find physicians who have experience with Syngap. We need to build this list to identify those who can both support clinical trials & see the growing number of patients.
We want to know about all the great clinicians you have out there. You can fill this form in again and again to let us know all the good people you have found!
On behalf of all the other patients who will benefit from this information, thank you.
Name of clinician
Type of clinician
Neurologist focusing on epilepsy aka Epileptologist
Equine (Horse) Therapist
GI - Gastroenterologist
Other (please explain below in the last question)
Please share a link to their bio.
Affiliation (What office, hospital or system do you see them through)
Location - US: Please share City/State or Zip if not full address. Other countries please share as much as you can including country!
How happy are you with this doctor (this will never be shared, just used internally).
I would not recomend this doctor to another SynGAP family.
This person is as good as they get!
How many other SynGAP patients do you think this doctors sees?
Any other information you'd like to share?
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This form was created inside of Syngap Research Fund.