Do you have an open communication with your healthcare team?

Yes   No

Does your current antiepileptic drug(s) provide enough seizure control?

Yes   No

Does your current antiepileptic drug(s) have little or no side effects?

Yes   No

Do you feel that your current antiepileptic drug(s) is/are the best possible alternative for treating your seizures?

If you answered "no" to any of these questions, it is important to discuss these concerns with your healthcare team.

Yes   No

Do you feel comfortable asking your Physician, nurses and other team members questions?

Yes   No

Does the team respect your role in making decisions about your healthcare?

Yes   No

Do team members answer your questions completely?

Yes   No

Have they given you materials about epilepsy that you can understand and that answer your questions?

Yes   No

Do they use words you understand, and explain words that you don't understand?

Yes   No

Is it easy to contact your Physician or a nurse when you have a question or a problem?

Yes   No

Has your team described all epilepsy treatment options, including medications and surgery?

Yes   No

Overall, are you satisfied with your team's efforts to help you?

If you answered "no" to any of these questions, it is important to discuss these concerns with your healthcare team.

Yes   No

Have you asked about the types of services the members of your healthcare team can provide?

Yes   No

Do you know whom to call about each type of service?

Yes   No

Do you take your medication exactly as directed?

Yes   No

Do you keep notes or a seizure diary of your seizures and medications?

Yes   No

Do you follow other parts of our treatment plan, including making healthy lifestyle changes?

Yes   No

Are you completely honest with your Physician and other team members about your condition and any problems you are having?

Yes   No

Do you write down questions and bring them with you to all visits?

Yes   No

Do you listen closely and take notes about what your healthcare team says?

Yes   No

Do you ask questions until you understand?

Yes   No

Do you make an effort to learn everything you can about epilepsy?

Yes   No

Do you take a friend or relative with you if you need help understanding the Physician's instructions?

Yes   No

If someone has seen you have a seizure, have you taken the person with you to describe it?

Yes   No

Do you go to all of your scheduled appointments?

Yes   No

When you need help, do you ask for it (including emotional support and financial help)?

If you answered "no" to any of these questions, you should consider becoming a more active part of your healthcare team.