Printable Epilepsy Forms – Epilepsy: The Untold Side

1. My Epilepsy Emergency Passport

Keep this somewhere easy to find. In an emergency, it can help unfamiliar healthcare staff understand what is usual for you.

Name

Date of birth

Emergency contact

Emergency contact number

Epilepsy diagnosis / known seizure types

What my usual seizure(s) look like

Usual seizure duration

Usual recovery time

What is normal for me after a seizure

Rescue medication / emergency instructions from my clinical care plan

Important allergies / adverse reactions

Other important medical information

Epilepsy clinician / service

Last updated

2. Current Medication List

Do not use this form to change a dose. It is a communication record. Medication changes should follow the person’s prescribing instructions.

Antiseizure medicines – name, formulation, dose and exact times taken

Other prescription medicines

Over-the-counter medicines, vitamins, supplements or herbal products

Rescue medicine prescribed

Medication allergies / important previous adverse reactions

Pharmacy / prescriber

Last updated

3. Seizure Witness Record

Describe what you actually saw. You do not need to identify or classify the seizure. Make the person safe before filming or taking notes.

4. My Usual Recovery After a Seizure

This records your usual baseline. A recovery that is substantially different from normal can be important information for carers and clinicians.

What my usual recovery looks like

Typical time until I can communicate normally

Typical time until I return to my usual baseline

What usually helps me during recovery

What should people avoid doing during my recovery?

Changes that my care plan says need urgent or emergency assessment

Completed with

Last updated

5. Epilepsy Appointment Preparation

Use this before an appointment so the issues that matter most do not get lost when time is limited.

Appointment date

Clinician / service

The main reason for this appointment

Seizures or changes since my last review

New symptoms or recovery changes

Medication changes, side effects, missed doses or supply problems

Tests / results I want explained

My most important questions

What was agreed / next steps

Who should I contact if I have questions?

Next review / follow-up

See the full appointment question guide →

6. Pocket Epilepsy Emergency Card

A compact quick-reference card for a wallet, purse or phone case. Keep detailed medication and emergency instructions in your full Emergency Passport or clinical care plan.

Epilepsy Emergency Card — Front

Name

Emergency contact + number

My usual seizure looks like

Usual seizure duration

I have epilepsy. Please use my individual care plan and usual seizure information rather than assuming every event is the same.

Epilepsy Emergency Card — Back

My usual recovery looks like

Rescue medicine / instruction from my clinical care plan

Important allergy / medical information

Last updated

If something is significantly different from my usual seizure or recovery, or there is another emergency concern, contact the appropriate local emergency service.