Download PDF Page Story Questionnaire - IndividualsThis form is for people experiencing epilepsy to submit their story to the Epilepsy Foundation.Personal InformationWhat is your name?What are your preferred pronouns?eg. she/her, he/him, they/themHow old are you?Which state are you based in?What is your email and/or phone number?We will only use these details to contact you about your submission.Your epilepsyWhat type of seizures do you experience, and what do they feel like for you?What is your first memory of a seizure?How did you feel when first diagnosed?What impact has epilepsy had on your life?What is the worst aspect of having epilepsy?Life outside of epilepsyAre you currently working or studying?How do your friends/family/loved ones support you?What do you most enjoy doing (hobbies, sports, volunteering etc)?Relationship with Epilepsy FoundationHow did you first hear about the Epilepsy Foundation?What are your thoughts on the Epilepsy Foundation?AwarenessWhat is your advice for other people living with epilepsy?What do you wish the public knew about epilepsy?Any final thoughts or words?Confirmation:* I confirm the above statements are true and correct. I consent to being contacted by the Epilepsy Foundation.