Epilepsy Review

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

Epilepsy Review

Epilepsy Review

Epilepsy Review

What is your smoking status? *
Would you like information to help you quit? *
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.

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