NC State Companion Animal Epilepsy Research Laboratory: Epilepsy & Sleep Screening Questionnaire

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We will be conducting an online survey exploring sleep in dogs diagnosed with idiopathic epilepsy. If you would like to be considered for this survey, please complete this brief screening questionnaire. Thank you

Email *

Dog's Name: *

Has your dog had a brain MRI scan (Magnetic Resonance Imaging?) *

Yes

N/A

Was the MRI scan normal (no masses or inflammation)? *

Yes

N/A

Is your dog receiving any anticonvulsants to treat seizures? *

Yes

If your dog is receiving anticonvulsants, please list the medications below (if no, please add n/a): *

A copy of your responses will be emailed to the address you provided.

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