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Epilepsy Anonymous Survey
1.
Do you know what epilepsy is?
Yes
No
Sort Of
2.
When you think of epilepsy, what words come to mind?
3.
Epilepsy is:
A family-related condition
Caused by unknown factors
A mental illness
Caused by evil spirts or witchcraft
I'm not sure
Caused by a head trauma
A contagious disease
Other (please specify)
4.
How would you describe epilepsy? Choose the closest options.
A blank out of the brain that causes someone to stare into space
Uncontrollable convulsions
A disruption of the electrical activity in the brain
A seizure disorder
Other (please specify)
5.
Do you know anyone who has epilepsy?
I have epilepsy
1 person
2 or more people
No
6.
What would you do if you had a seizure or blank out regularly?
Ignore it and not tell my family
Look for information online
Record it so I can show a medical professional
See if it happens again
Go to the clinic, doctor or nurse
Ask a friend or family member what I should do
Other (please specify)
Current Progress,
0 of 17 answered