Global Genomic Variants Registry for Epilepsy Online Application Form

Complete the application below to describe your proposed research and request use of existing registry data.  If approved, the registry team will work with you to craft a description of your study and send it to applicable families. Registry participants will have the opportunity to reach out to your research team if they would like more information or would like to consent.

A complete application includes:

  • This completed form.
  • A biosketch or CV for the lead investigator.
  • IRB approval letter, if applicable.

 Once your application is final, it will take approximately 2-3 weeks for it to be reviewed and discussed by the Registry Steering Committee.

Download the application by clicking here.

 Email completed application and associated documents to