Answer these four questions on a video you record directly from your phone.

When did you first get diagnosed with epilepsy?

What are your greatest challenges as a woman/girl living with epilepsy?

What do you wish others knew about living with epilepsy?

Tell us what being apart of this Mosaic means to you.

 

Please email videos to Education@MyEpilepsyStory.orgĀ 

Provide your contact information in the email

Please add that you grant permission to My Epilepsy Story (MES) to use your video and images

First Name
Last Name
Email
Phone
Video Attachment
I grant My Epilepsy Story the rights to use this file