Hello! We at Samman Association (epilepsymumbai.org) work towards empowering people with epilepsy and request your participation in this survey. This will help us to better serve and guide people with epilepsy and employers. This information is CONFIDENTIAL and will be used only for purposes of this research. The form does not ask for any details regarding your personal identity.

Who can take this survey?
Adults with epilepsy (21-60 years), employed or unemployed, living in India, having at least one year of confirmed epilepsy diagnosis.

Please note-

• Respond to this questionnaire based on your work situation BEFORE the COVID 19 lockdown. This form needs to be filled in one sitting and takes approx. 10 minutes.
• Please do not answer if you are a full time student or have any chronic or psychiatric ailment besides epilepsy, that could interfere with your ability to procure employment.
• If you’ve already taken part in this survey through a personal or telephonic interview, do not fill this form.

Survey link – https://forms.gle/quU7cT7n49uyy7b77

For more clarity regarding any question, please email us at [email protected].
For any further queries or help, contact us: +91 99304 01870. Thank you for your time and cooperation.