We are a branch of a larger market research company, whose goal is to make contact with individuals diagnosed with EPILEPSY. In the coming weeks, we will reach out to those interested in participating in on-line surveys or telephone discussions to help understand the treatment decision process. When contacted and qualified we will pay respondents for their time (up to $100).

This project is solely concerned with marketing research and there will be no attempts to sell you anything or influence your pharmaceutical or treatment options in any way.

Our clients range from not-for-profit organizations, advertising agencies, advocacy groups and pharmaceutical companies. We work with them as an independent research company to gather the opinions of individuals closest to various disease groups. We have worked in a number of different disease areas including diabetes, autism, Fragile X, hemophilia and many more.

All information collected during the surveys or phone discussions will be completely confidential in that we will not show your name or any other identifying information to our clients.

* 1. Are you the patient or caregiver?

* 2. If known please identify type of Epilepsy diagnosed.

* 3. How many seizures has the epileptic person had in the last 12 months

* 4. What treatments and / or medication(s) have/are you utilizing to manage your EPILEPSY? Select those that apply to current and previous management.

  Current Previous
phenytoin (Dilantin®)
carbamazepine (Tegretol®)
valproate (Depakote®)
lamotriqine (Exalgo®)
levetiracetam (Keppra®)
Phenobarbital
Diet
Neurostimulator

* 5. Please provide information for us to contact you when telephone/internet survey is scheduled. Name, address and phone numbers are optional.

Thank you very much for taking the time to fill out this short qualifying questionnaire. We are collecting basic information to match individuals with specific survey requirements in order to invite your valued participation.

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