Epilepsy and Wellbeing Screening

You have been asked to complete the following questionnaires by your child’s doctor or speciality nurse. The questions are about your child’s mental health and wellbeing.

In your next appointment, your doctor or speciality nurse will go through your answers. They will discuss supports that may be helpful.

GDPR compliance and consent statement

Data collection and processing
We are committed to protecting your privacy and ensuring the confidentiality of your personal and health-related information. By completing this questionnaire, you consent to the collection and processing of your and your child’s personal and health data for the purpose of routine care and management of epilepsy and mental health by the NHS.

Consent
Your participation in this questionnaire is voluntary, and by submitting the responses, you provide explicit consent for the processing of your and your child’s special category data, including health-related information, in accordance with the General Data Protection Regulation (GDPR).

Data security
We will ensure that your data is securely stored and processed in compliance with GDPR requirements to safeguard your privacy and confidentiality.

Privacy policy
For more information on how your data will be handled, please refer to our privacy policy, which can be found at https://www.hacw.nhs.uk/privacy-notice.

Contact information
If you have any questions or concerns regarding the collection and processing of your data, please contact us at england.cyptransformation@nhs.net.

By using this tool, it will enable us to provide you with tailored support for your care needs. Completion of the tool is optional, and you can still access our service if you choose not to complete it. If you don’t want to complete it online, you can complete a paper version at your next appointment. The information provided will be used to evaluate how effective this tool is, but this will not use information that identifies you.

If you choose to participate in this programme, we will collect data about you and your health through this online form. This will be shared with the team providing your care. We will use anonymous data (that does not identify you) to evaluate the programme, to see if it has helped patients.

Please contact your care team if you require more information.

Please click next if you are happy to continue