Epilepsy annual review
We are using this secure online system to help assess your epilepsy, complete a medication review if required, and gather some relevant lifestyle information. Your answers will always be seen by the practice team, and you can indicate at the end if you feel further discussion is needed.
OPTIONAL: You can submit your weight and height
SAFETY: Your answers will be attached to your medical record but may not be seen immediately. This system should never be used if you are in need of urgent medical attention. In this event, please contact the appropriate services (999 or 111) or the practice as normal.
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Practice Name - OFFICE USE ONLY
This review is only for patients registered at the practice below. Please do not alter
Data Processing Notice
Who is this for?
Please note that anyone under 18 can only have this review completed by a parent or guardian on their behalf
I am completing this for myself
I am completing this for my child
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