Gulf Coast Epilepsy Alliance (GCEA)

New Members, Referrals & Annual Renewals Form

Welcome to our Membership Page!

Become a member of GCEA today for just $25. With your membership, enjoy complimentary admission to all our events throughout the year.

Thank you for your support and for becoming part of our community!

* Date:

* Is this submission for a New Member, a Referral, or an Annual Renewal?

* My connection to epilepsy is:

* Does the member have epilepsy, seizures, or a brain disorder?

* First Name

* Last Name

Address

City

State

* Postal Code

* Phone

* Email

* Gender

Birthday

An epileptologist is a neurologist who specializes in the diagnosis, treatment, and management of epilepsy, also known as seizure disorder , in people of all ages. Epileptologists have additional training and education in diagnosing and managing various kinds of seizures. They can also help manage the social and emotional aspects of epilepsy.

* Are you seeing a Neurologist or an Epileptologist?

* Please include your Doctor's first name, last name, and contact information.

Please list diagnosis and medications:

Nayzilam (midazolam) and Valtoco (diazepam) are nasal sprays that are approved by the FDA to treat seizure clusters in adults and children. Nayzilam is for patients 12 and older, while Valtoco is for patients 6 and older. These medicines are considered rescue therapies, but are not approved for daily use.

* Are you using a seizure rescue medication? If so, what type and name of medication?

Social Security Administration (SSA) Assistance Program: GCEA proudly facilitates exclusive bi-monthly meetings with Social Security Administration. We provide assistance to guide individuals through the complexities of the Supplemental Security Income (SSI) application process.

* Do you need assistance with Social Security Benefits / SSI / assistance with state applications?

Canine Partners Program: Enhancing the lives of our members with epilepsy, seizures, or brain disorders by providing them with service dogs, including comprehensive medical care for the lifetime of the dog.

* Are you interested in applying for a service dog through our Canine Partners Program?

SUDEP stands for Sudden Unexpected Death in Epilepsy. According to the National Institutes of Health, SUDEP is the most common epilepsy-related cause of death. A discussion with your doctor to determine where you or your loved one fall on the risk spectrum is very important.

* Are you aware of S.U.D.E.P, seizure alerting or prediction devices, and related technologies that are designed to enhance safety for a person with epilepsy?

In 2015, Texas passed the Compassionate-Use Act, which allowed the first legal use of low-THC cannabis products in the state for patients with intractable epilepsy. It was expanded in 2019 and 2021 to include other conditions.

House Bill 684 was signed into law on June 11, 2019 with Governor Greg Abbott, two GCEA Representatives and many Texas Epilepsy Advocates. The law requires all Texas ISD public school personnel whose duties include regular contact with students to be trained in seizure recognition and seizure first aid.

* Are you aware of the Texas Compassionate-Use Act and House Bill 684? Please visit our website to learn more.

Additional information you would like to share:

* How may we help you? Please note, GCEA meets online every 2nd Thursday, monthly, to answer all your questions and medical concerns. See you there!

* Would you like to volunteer with GCEA?

* May we highlight your story on social media? Personal stories help us raise awareness and advocate for our cause. Please provide your full name below to give us consent: [Full Name]

* May we use your photo for marketing on our social media? Photos help us raise awareness and advocate for our cause. Please provide your full name below to give us consent: [Full Name]

Reminder: Annual Membership is $25.00. Click on the SUBMIT button below and you will be redirected to make your payment at gceaTX.org/ways-to-give.

GCEA is a 501(c)(3) charitable organization, all contributions are tax deductible. Your generous donation will fund Gulf Coast Epilepsy Alliance's mission. EIN# 84-2099498

Thank You For Your Support!

THANK YOU FOR YOUR SUPPORT!

Est. 2019, Gulf Coast Epilepsy Alliance (GCEA) is dedicated to providing essential services and support to individuals affected by epilepsy, seizures, and other brain disorders.
Did you know?
1-in-10 will have a seizure in his or her lifetime and 1-in-26 will be diagnosed with epilepsy. [cdc.gov]
Learn Seizure Safety with GCEA!

Through generosity of foundations, corporations and individuals, GCEA is making a real difference in the lives of those touched by epilepsy, seizures and brain disorders across the Coastal Counties of Texas.

GCEA is a 501(c)(3) charitable organization, all contributions are tax deductible. Your generous donation will fund Gulf Coast Epilepsy Alliance's mission.

EIN# 84-2099498