Update Your Address | Epilepsy Foundation of Idaho

At the Epilepsy Foundation of Idaho, we want to ensure that you receive:

current details regarding seizures
news on our programs that help educate and connect people
information on opportunities to get engaged in ending the stigma associated with epilepsy

Help us by making sure your contact information is current, and that we have the information we need to best serve you! Please complete this online form—updating us on your contact information and your relationship to epilepsy. Birthdates will ensure that you receive age-appropriate information.

Your privacy is important to us—and we will not share this information with any other organization. If you have any questions regarding your information, please call us at 208-344-4340.

Update your contact information

You can use this form to update your contact information, to be added to our mailing list, or to be removed from our mailing list. All fields are optional.

Update Your Contact Information

Name
FirstLast
Address
Street AddressAddress Line 2CityStateZip Code
Email
Please enter a valid email address.
Phone
Please enter your 10 digit phone number.
Please give us the name of the person with epilepsy:
Date of birth of the person with epilepsy:
MM
DD
YYYY
Gender of the person with epilepsy:
What is your relationship to epilepsy? (Mark all that apply)
- I have epilepsy
- My child has epilepsy
- My spouse/partner has epilepsy
- Another family member has epilepsy
- I work with people with epilepsy
- Other
Mailing List Preferences
- Add me to your mailing list
- Remove me from your mailing list