STEP 1:CHOOSE YOUR PLAN |
Forms are below and must be opened in Adobe Acrobat Reader. This is an editable PDF for you to complete. We recommend completing this form on the computer and not completing it by hand to allow for any revisions by your medical practitioner
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STEP 2:THREE WAYS TO HAVE YOUR PLAN COMPLETED |
You can access Guidelines on how to complete these documents by clicking here.
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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.
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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.
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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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An EMP is a great way of ensuring that all the people in your life understand your epilepsy and how you want to be supported. The plan must be endorsed by your doctor. It’s important to update your plan at least once a year, or earlier if anything related to your epilepsy and treatment changes.
Click the link below to download the Epilepsy Management Plan template.
We recommend completing this form on the computer and not completing it by hand to allow for any revisions by your medical practitioner.
Epilepsy Management Plan Guidelines (Editable PDF)
Epilepsy Management Plan – 1 Seizure Type (Editable PDF)
Epilepsy Management Plan – 2 Seizure Type (Editable PDF)
Epilepsy Management Plan – 3 Seizure Type (Editable PDF)
Epilepsy Management Plan – 4 Seizure Type (Editable PDF)
Epilepsy Management Plan – 5 Seizure Type (Editable PDF)
Seizure Management Plan Guide (Editable PDF)
Seizure Management Plan – 1 Seizure Type (Editable PDF)
Seizure Management Plan – 2 Seizure Type (Editable PDF)
If the person with epilepsy has more than two seizure types please contact us via our contact us form or phone our National Epilepsy Support Service on 1300 761 487.
Some people with seizures that are difficult to control are prescribed emergency medication. If have been prescribed emergency medication, it is highly recommended that you work with your doctor to complete an Emergency Medication Management Plan (EMMP). An EMMP describes:
Your EMMP should be updated annually, or earlier if anything related to your epilepsy and emergency medication changes. Your EMMP should be attached to your EMP so that all the information related to your epilepsy is kept in one place.
Click on the link below to download the Emergency Medication Management Plan template.
We recommend completing this form on the computer and not completing it by hand to allow for any revisions by your medical practitioner.
Emergency Medication Management Plan Guide (Editable PDF)
Emergency Medication Management Plan – Midazolam (Editable PDF)
Emergency Medication Management Plan – Midazolam Zyamis (Editable PDF)
Emergency Medication Management Plan – Clobazam (Editable PDF)
Emergency Medication Management Plan – Clonazepam (Editable PDF)
Emergency Medication Management Plan – Rectal Valium(Editable PDF)
Generic Emergency Medication Management Plan (Editable PDF)
Our Epilepsy Support Workers are available to assist you to understand and complete an EMP and EMMP. Contact our National Epilepsy Support Service on 1300 761 487 for assistance.
