Exit this survey Epilepsy Self Management Scale 1. About you This survey can be taken alone or may be taken along with the Survey of Seizure Experience. Question Title Which of the following apply to you? I am taking this survey only I am taking this survey along with the Survey of Seizure Experience (Australian Version) I am taking this survey along with the Survey of Seizure Experience (American Version) Question Title Please indicate today's date Day Month Year Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Date Day menu January February March April May June July August September October November December Date Month menu 2011 2012 2013 Date Year menu Next