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Completing Epilepsy Smart Forms

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The Epilepsy Management Plan and Emergency Medication Management Plan forms are provided in PDF format. This makes them easily accessible to everyone. To work properly, the forms must be opened using Adobe Acrobat Reader, a free application that you can easily download. Unfortunately, opening them with other applications, including your web browser will disable some parts of the forms.

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HOW TO DEVELOP YOUR MANAGEMENT PLAN

How to Develop your Management Plan

STEP 1:
CHOOSE YOUR PLAN
  1. If you or the person you support have a diagnosis of epilepsy select an Epilepsy Management Plan (EMP) template. Choose the template based on how many different seizures types you or the person you support experience.
  2. If you or the person you support experience seizures but do not have an epilepsy diagnosis (e.g. febrile seizures), choose a Seizure Management Plan (SMP) template. Choose the template based on how many different seizures types you or the person you support experience.

Forms must be opened in Adobe Acrobat Reader. 

This is an editable PDF for you to complete.

 

 

STEP 2:
THREE WAYS TO HAVE YOUR PLAN COMPLETED
  1. Complete by yourself:  After downloading the plan you can complete the document yourself or with your family.
  2. Seek support from your local epilepsy organisation:  For support with completing the plan, you can contact the National Epilepsy Support Service on 1300 761 487 who can refer you to a local epilepsy support organisation, if required.
  3. Complete with your medical practitioner or other support person.

You can access Guidelines on how to complete these documents by clicking here.

 

 

STEP 3:
GET YOUR PLAN ENDORSED

All plans need to be endorsed by a medical practitioner.

The plan can be endorsed by a GP, neurologist, paediatrician or other relevant medical practitioner.

 

 

STEP 4:
IS EMERGENCY MEDICATION PRESCRIBED?

If no – you are all done!  Provide your endorsed management plan to those who may need to support you or the person you are supporting during a seizure.

If yes – you will require an Emergency Medication Management Plan (EMMP) relevant to the emergency medication you have been prescribed. Contact your medical practitioner for assistance in completing and endorsing this document. Alternatively, you can contact the National Epilepsy Support Service on 1300 761 487 for a referral to a local epilepsy support organisation.

 

 

STEP 5:
REVIEW YOUR PLAN
Your plan will need to be reviewed annually according to the date on the document unless there are any changes to seizure presentations or if emergency medication has been introduced.
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The Epilepsy Smart Australia program received funding from the Australian Government.