Get Seizure Action Plan 2020-2026

Filling out a Seizure Action Plan is essential for ensuring the safety and well-being of students with seizure disorders during school hours. This guide will provide you with a clear and detailed approach to completing the form online, ensuring you have all the necessary information at hand.

Follow the steps to complete the form effectively.

1. Press the ‘Get Form’ button to obtain and open the Seizure Action Plan in the online editor.
2. Begin by entering the student's name and date of birth in the designated fields. This key information identifies the individual covered by the plan.
3. Input the parent or guardian's contact details, including their phone number and cell number. Additionally, provide information for another emergency contact.
4. List the treating physician's name and phone number for medical reference during emergencies.
5. Describe the significant medical history related to the seizure disorder briefly but comprehensively.
6. Specify the seizure type, average length, and frequency in the appropriate sections. Include any known triggers or warning signs of a seizure.
7. Detail the student's response after a seizure occurs, and provide necessary first aid responses in the designated area, referring to the basic first aid guidelines.
8. Indicate whether the student needs to leave the classroom after a seizure and describe the process for returning them if applicable.
9. Define what constitutes a 'seizure emergency' for the student by checking relevant criteria listed in the form and providing additional descriptions as necessary.
10. Outline the emergency response process, including whom to contact and what actions to take based on the specified protocols.
11. Document any treatment protocols that need to be adhered to during school hours, listing all medications with dosage and timing.
12. If applicable, indicate whether the student has a Vagus Nerve Stimulator and provide any relevant special instructions or common side effects.
13. Describe any special considerations or precautions regarding the student's participation in school activities, trips, or sports.
14. Ensure that the treating physician and the parent or guardian sign the completed form, along with the date of signature.
15. Finally, save your changes, and select the options to download, print, or share the Seizure Action Plan as needed.

Complete the Seizure Action Plan online today to ensure the safety and well-being of your student.