Join our ESF Family of Support

By completing the form below, you’ll be entered into our secure, coordinated network of community resources, powered by Unite Us, that is available to help. A specialist will contact you after you submit the form.

The client is the youth with epilepsy and you should use the child’s/youth’s name and date of birth, but include contact information for the parent or caregiver.

 

Your privacy is a primary concern to the Epilepsy Services Foundation, Inc. Our goal in expanding and clarifying our procedures for the collection and use of data is to ensure confidentiality and security. When you provide your personal information to the Epilepsy Services Foundation, Inc. (name, address, phone number, or donation information) we will not give or sell your individual information to any outside company for its use in marketing or solicitation. We will maintain the confidentiality of your personal information and it will be used only to support your relationship with the Epilepsy Services Foundation, Inc.

At any time, you have the right to ‘opt out’ of receiving future communications but sending us an email at [email protected].

Information that we collect about our families is private. Many funding sources require the collection of data. Your information will remain confidential in our records and only aggregate data with no personal information will be used as needed to secure funding by reporting statistical data about the families that we serve. This website is public domain and, therefore, does not contain any private consumer information.

Thank you for visiting the Epilepsy Services Foundation Inc.  on-line and thank you for your support as we continue to assist children, teens and young adults with epilepsy and their families that we serve in west central Florida.