Caution: JavaScript execution is disabled in your browser or for this website. You may not be able to answer all questions in this survey. Please, verify your browser parameters.

H.1991-0421- Dravet Syndrome

You are about to fill in a short survey which will help determine your suitability to this research project. Please be aware that all data you provide us with will be held in accordance with the data protection policy outlined on our website. For further information please visit https://www.healthcareopinions.co.uk/privacy-policy/

(This question is mandatory)
Are your details currently registered with us? If you haven't, please do so here http://https://www.healthcareopinions.co.uk/
(This question is mandatory)
Where did you hear about this research participation opportunity?
(This question is mandatory)
What is your name, contact number and email address?
(This question is mandatory)
Please tell us your age.
(This question is mandatory)
Are you...
To ensure we are speaking to a representative sample, how would you describe your ethnic background? 
(This question is mandatory)
To ensure we are speaking to a representative  sample, what is the occupation of the chief income earner  in the household? 
(This question is mandatory)
Are you currently providing care for a family member who has been diagnosed with Dravet Syndrome? 
(This question is mandatory)
What is your relationship to the person you provide care fo? 
(This question is mandatory)
What is the age of the person you provide care fo? 
(This question is mandatory)
When did the person you provide care for receive a diagnosis for Dravet Syndrome? 
Are you involved with any patient groups in relation to Dravet Syndrome? 
(This question is mandatory)
If applicable, which patient groups in relation to Dravet Syndrome are you involved with?