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The Robert Darbishire Practice NHS GP Surgery in Manchester

Epilepsy review

Epilepsy Review

How long has it been since your last epileptic fit?

Within the last week

1 to 4 weeks

1 to 6 months

6 to 12 months

Over 12 months

Are you currently on treatment for epilepsy?

Yes

How often do you have an epileptic fit?

None

Many seizures a day

Daily seizures

1 to 7 seizures a week

2 to 4 seizures a month

1 to 12 seizures a year

Are you a woman aged between 18 and 55?

Yes

Would you like some information regarding contraception, conception and pregnancy and how this is affected by your epilepsy medication?

Yes

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

Please let us know your availability for a telephone call with a nurse. Tell us the day and whether you’d prefer a call in the morning or afternoon: *

Confirmation *

I confirm that the information provided is accurate to the best of my knowledge

Confirmation *

I confirm that I have been advised by a member of staff to complete this review

If you are human, leave this field blank.

Rusholme Health Centre
Walmer Street
Manchester
M14 5NP

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0161 225 6699

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