MODULE 3: Epilepsy Support and Non-medication Management 41 Teen Seizure Action Plan3,4 This person is being treated for a seizure disorder. The information below may be helpful if you are present when the person has a seizure, or as the person is recovering. Name Address Date of birth Parent/Guardian Emergency Contact Name Phone Other Emergency Contact Name Phone Important Medical History My Seizure Information Seizure Type Length Frequency Description Seizure Triggers or Warning Signs Usual Response After a Seizure Daily Seizure Medications Medication Name (brand name and generic name) Medication Dose (how many milligrams, or mg, in each pill) How Many Pills Do You Take and How Many Times Per Day (instructions on the prescription bottle)