Pilot Samsung Users Survey

Guardian Email

Thinking about the seizures your loved one usually experiences, how intense is the repeated jerking or shaking?

None - no repeated jerking or shaking

Mild - small or brief jerking, not sustained

Moderate - clear repeated jerking for a short period

Strong - continuous, pronounced jerking for an extended period

Not sure

Please describe what a typical seizure looks like for your loved one.

(For example: any jerking or shaking, how long it lasts, changes in awareness, breathing, or other noticeable)

Please confirm the following before submitting:

I confirm that I am the parent or legal guardian of the individual described and am authorized to provide this information. Participation in this survey is voluntary. By submitting this form, I consent to the collection and use of the information provided, including health-related information, for the purpose of evaluating eligibility for the pilot program and improving AngelSense’s products. Submission does not guarantee selection. Information will be handled in accordance with the Privacy Policy

If you are human, leave this field blank.

Pilot Samsung Users Survey

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