Doctor Registration

Professionals interested in being included:

Complete this form to be included on our “Find A Doctor” page.

All information is moderated by DSF staff, so please allow some time before doctors appear on the “Find A Doctor” page.

Be sure to include a valid email address so we can contact you with any questions.

* indicates required

 Have you in the past and/or are you currently treating patients with Dravet syndrome (SMEI)?

 Have you in the past and/or are you currently treating patients with GEFS+ or SMEB?

 Have you in the past and/or are you currently treating patients with unspecified forms of intractable childhood epilepsy?

How many patients do you see who are on the ion channel epilepsy spectrum?

 I am the above referenced person or have been authorized by that person to complete this form on their behalf.

 I allow DSF to use this information on its Professional Resources page as DSF sees fit.

 I would like to receive the quarterly DSF Research Newsletter via email.