Pre-screening Questionnaire

Epilepsy

Recruiting

Female

18 - 75 years of age

Compensation Provided

Please enter your legal name, a valid phone number, and a valid email address where you can be contacted.

First Name

Last Name

Phone

Email

Gender

Age

Preferred Language

Please answer the following questions to determine your eligibility for this study.

Are you between 18 and 75 years of age?

Yes

No

Have you been diagnosed with Focal Onset Epilepsy at least 1 year ago?

Yes

No

Are you currently taking 1 to 3 anti-seizure medications?

Yes

No

You can call, email, or text me about current or future studies.

We will contact you shortly. Please check your email for additional instructions.