What is your name?

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* 1. What is your name?

What is your Child/ Childrens Names?

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* 2. What is your Child/ Childrens Names?

What is your address?

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* 3. What is your address?

What is your email address?

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* 4. What is your email address?

What was the name and dosage of your medication?

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

Did you take this medication DURING pregnancy?

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* 6. Did you take this medication DURING pregnancy?

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

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

Does Your Child/Children Have a Diagnosis of FACS ?

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

What are your childs/childrens symptoms of FACS?

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

What support do you receive from NHS and Education?

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

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