ILAE Global Health Project Database
Please complete this brief survey to help us populate the ILAE database of global health projects in Epilepsy. This will help us to facilitate recruitment, collaboration and success of your projects.  

To view the database, please find it at the link below:
https://www.ilae.org/regions-and-countries/regions/ilae-north-america/global-health-database

For questions/comments or to request changes to an existing database entry, please email GlobalHealth@ilae.org
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Title/Name of Project or International Outreach Program *
Brief Description of Project (50-100 words maximum please) *
Project Status *
Start Date *
MM
/
DD
/
YYYY
End Date (proposed)
MM
/
DD
/
YYYY
Location of Project (Country and City) *
ILAE Region *
Language(s) Spoken *
Required
Name of Institution or Agency Where Project is Taking Place *
Name of Principal Investigator or Organizer *
Affiliation of Principal Investigator (Institution/Society) *
Contact Person (Name and Affiliation) *
Contact Person Email Address *
Patient Age *
Required
Type of Project *
Required
Funding Source *
Required
Project Needs *
Required
Publications Associated with the Project (please limit this to PMID only when available)
Ethical Attestation *
The information I have provided is accurate to the best of my knowledge and I give permission for the ILAE to add this project to their database for public view. I am in agreement with the Creative Commons Attribution-ShareAlike 4.0 International License as stated on the ILAE website. I will contact the ILAE to update this information if it should change in the future or if the project ends. *
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