http://www.wisconsinseizure.net
Care Notebook
A care notebook is a tool for you to keep track of your child’s medical information, special needs and services. All of the sections in the notebook may not be helpful to everyone.
Select the sections and forms that work best for you and your child. Fill out the information in the notebook at your own pace. It may be helpful for you to bring your care notebook to medical appointments. Your child’s healthcare providers can use this notebook to learn more about your child and their epilepsy.
You can also share the information in the notebook with others who care for your child.
Please use the free Adobe Reader software for viewing the PDF files.
Introduction
- Epilepsy care notebook - labels
- Care notebook - cover
- What is a Care Notebook?
- Dear Epilepsy Parents
- Personal Page
Seizure Record
Emergency Information
Use this section to store your child’s emergency plan of care.
Emergency Information
Health Care Providers
Phone Log
Medication Record
Herbal Medicines/Home Treatments
Care Plan
Use this section to store the care plan that you receive from your child’s healthcare provider.
Appointment
Therapies
Lab
X-rays and Procedures
Clinic Notes
Use this section to store notes from your child’s clinic appointments.
Medical History
- Summary of Past Medical History
- Immunization Record (English)
- Vacunas (Immunization Record - Spanish)
Insurance
School
- Initial History Form for Student with Seizures
- Seizure Emergency Action Plan - page 2
- Seizure Observation Record
Epilepsy Information
- Caring for Your Child During a Seizure (English)
- Cuidado de un ninõ durante una convulsión (Caring for Your Child During a Seizure - Spanish)