Epilepsy Online Review

Epilepsy Online Review

If you have been asked to submit an online epilepsy review, please complete the below form

  • Your Details

    Date of Birth
    For example, 15 3 1984

  • Lifestyle

    Please answer the following lifestyle questions.

    Alcohol unit calculator available by following this link to Alcohol Change UK

    For information and support to help you stop smoking, please follow this link to Smoke Free Highland

    Smoking Status
    Do you vape?
    Alcohol Consumption

  • About Your Epilepsy

    Please complete the below questions about your epilepsy, to the best of your knowledge

    Are you currently seen and reviewed by an epilepsy specialist nurse or consultant?
    Have you attended a Hospital or Accident and Emergency Department due to a seizure in the last 12 months?
    Do you (or a carer) have a written seizure plan?
    Do you have a learning disability or require additional support?
    Please confirm you are aware when to seek help in an emergency, including when to contact 999?

  • Epilepsy Medications

    Please complete the following questions about the medications you currently take for epilepsy

    For further information about pregnancy and epilepsy, including medication usage please follow this link to further information from Epilepsy Scotland

     

    Do you miss any doses?
    Are you currently using contraception?
    Are you currently planning a pregnancy?
    In the last 12 months, have you received any information or discussion about taking epilepsy medications while pregnant? (Please see above link)
    Please confirm you are aware that should you wish to become pregnant, you would require to take 5mg of folic acid?

  • Further Information

    Please follow this link for further information about driving and epilepsy from Epilepsy Scotland

    Please follow this link for further information about SUDEP from Epilepsy Scotland

    Do you currently hold a driving licence?
    Have you informed the DVLA of your diagnosis of Epilepsy?
    Please confirm you have considered the information in the above link considering driving and epilepsy?
    There is a rare condition, SUDEP, that can cause unexplained early death in Epilepsy - please confirm you have considered the information enclosed in the above link
    Do you have any questions regarding your epilepsy you wish to discuss with your Doctor or Practice Nurse?
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Page last reviewed: 15 September 2025
Page created: 15 September 2025