Epilepsy Review

If you have been advised by the surgery to submit a epilepsy review please use this form.

Epilepsy Review

Epilepsy Review

About You

Please use this date format: DD/MM/YYYY.

Epilepsy Review

How long has it been since your last epileptic fit?
Are you currently on treatment for epilepsy?
How often do you have an epileptic fit?
Are you a woman aged between 18 and 55?
Would you like some information regarding contraception, conception and pregnancy and how this is affected by your epilepsy medication?

Please make an appointment with a practice nurse to discuss this further.

Sending