* 1. What is your name?

* 2. What is your Child/ Childrens Names?

* 3. What is your address?

* 4. What is your email address?

* 5. What was the name and dosage of your medication?

* 6. Did you take this medication DURING pregnancy?

* 7. Did you receive any advice about AEDs before/during pregnancy?

* 8. Does Your Child/Children Have a Diagnosis of FACS ?

* 9. What are your childs/childrens symptoms of FACS?

* 10. What support do you receive from NHS and Education?

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