Animal Relationship to Seizures in Human Study
If you have or have had seizures and lived with an animal during that time, please provide the following information. All personal/medical information shall be kept strictly private. Thank
you for your participation in this study. Study information will be compiled for one year. The results will eventually be posted on the SARA website at: www.affluent.net/sara
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What type of seizures do you have? How long have you had seizures?
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This animal primarily lives:
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Based upon your experience with this particular animal, do you believe the animal could predict your seizures in advance?
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What things do you notice the animal doing shortly (1 hour or less) PRIOR TO the seizure or during auras? Select all that apply.
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Based upon your experience with this particular animal, do you believe the animal somehow responded during a seizure.
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Based upon your experience with this particular animal, do you believe the animal responded after the seizure?
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What impact did the animal make on your overall health?
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What impact did the animal make on your seizures?
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Do you think that the animal somehow caused a reduction in the number of seizures?
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Do you think that the animal somehow caused a reduction in the severity of seizures?
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The animal helped to improve my emotional state or depression.
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Do you believe the animal allows you to engage in more activities than before?
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Do you believe that the relationship with this animal has increased your confidence?
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Has the animal helped to reduce the amount of anti-seizure medication/s you take.
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Do you believe this animal is important to your health and/or well being?
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Please provide any additional comments you think will assist in this study. If we may contact you, please provide your mailing address.
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