Virtual Epilepsy Monitoring Form
About this free form template

Streamline Epilepsy Care with Digital Monitoring

Managing epilepsy requires consistent monitoring between neurologist appointments, and this Virtual Epilepsy Monitoring Form makes it simple for patients, caregivers, and healthcare providers to track seizure activity, medication levels, trigger patterns, and device programming—all through a secure, telehealth-friendly platform.

Built with Paperform, this template is designed specifically for neurology practices, epilepsy centers, telehealth providers, and specialist clinics that need to maintain continuous care for epilepsy patients without requiring constant in-person visits. Whether you're a neurologist managing a large patient panel, a nurse coordinator tracking treatment responses, or a telehealth platform providing remote monitoring services, this form gives you a structured, HIPAA-aware workflow that captures the clinical detail you need.

What makes this epilepsy monitoring form essential?

Epilepsy management is uniquely data-intensive. Between appointments, patients experience seizures, adjust medications, identify triggers, and may have vagus nerve stimulator (VNS) settings that need optimization. Without a clear system for capturing this information, critical details get lost, treatment adjustments are delayed, and patients feel unsupported between visits.

This form solves that by creating a centralized intake point for:

  • Seizure diary uploads – Patients or caregivers can upload seizure logs, video recordings, or written diaries directly through the form
  • Recent medication level results – Lab results for anti-epileptic drug (AED) levels can be documented or uploaded, ensuring dosing decisions are informed by current pharmacokinetics
  • Trigger identification – Structured questions help patients identify and report seizure triggers like sleep deprivation, stress, missed medications, or hormonal changes
  • VNS programming feedback – For patients with vagus nerve stimulators, the form captures current settings, perceived efficacy, side effects, and any programming adjustment requests

All submissions flow into your patient management system via Paperform's native integrations with Google Sheets, Airtable, or your EHR (via Stepper workflows or Zapier), creating a continuous record that supports better clinical decision-making.

Who benefits from this template?

This form is built for healthcare providers and organizations focused on neurology, epilepsy care, and chronic disease management, including:

  • Neurologists and epileptologists who manage patients with complex seizure disorders and need regular updates between clinic visits
  • Telehealth platforms offering remote epilepsy monitoring and consultation services
  • Epilepsy centers and specialty clinics coordinating care for patients with refractory epilepsy, VNS therapy, or ketogenic diet protocols
  • Nurse coordinators and care managers responsible for tracking patient status, triaging concerns, and scheduling follow-ups
  • Pediatric neurology practices where caregivers are the primary reporters of seizure activity and medication adherence

The form's clean, accessible design ensures it works for patients and caregivers of all ages and tech comfort levels, whether accessed on mobile, tablet, or desktop.

How Paperform enhances epilepsy monitoring workflows

Paperform's document-style editor lets you customize every question, add helpful instructions, embed instructional videos about seizure tracking or VNS use, and apply conditional logic so patients only see questions relevant to their treatment plan (e.g., VNS questions only appear if they indicate they have a device).

The file upload field accepts seizure diaries, lab reports, and even video documentation of seizure events, keeping everything linked to a single submission. You can set file type restrictions and size limits to ensure submissions are manageable and secure.

With email notifications and conditional routing, you can automatically alert the right clinician when a submission indicates concerning seizure frequency, medication side effects, or device malfunction. Custom confirmation emails can reassure patients their information was received and let them know what to expect next—whether that's a follow-up call, medication adjustment, or scheduled telehealth visit.

For practices handling high submission volumes, Paperform's AI Insights can summarize trends across patient cohorts, highlighting common triggers, medication adherence patterns, or VNS programming issues that warrant clinical review.

Automate follow-up with Stepper

For practices ready to take workflow automation further, Stepper (stepper.io) can turn each form submission into a multi-step care pathway. When a patient submits their monitoring form, Stepper can:

  • Create or update the patient record in your EHR or CRM
  • Route high-priority submissions (e.g., increased seizure frequency, medication concerns) to the on-call neurologist
  • Schedule follow-up telehealth appointments automatically based on submission content
  • Send medication reminders, educational resources, or pre-visit preparation instructions
  • Log data into research databases or quality improvement registries for epilepsy programs

This means your clinical team spends less time on administrative coordination and more time on direct patient care, while patients experience faster, more responsive support.

Built for trust, privacy, and compliance

Healthcare data is sensitive, and Paperform takes that seriously. The platform is SOC 2 Type II compliant, offers data residency controls, and integrates with secure, HIPAA-compliant storage and communication tools when configured correctly. While Paperform itself is not a HIPAA-covered entity, it provides the infrastructure needed to build privacy-conscious workflows that meet your organization's compliance requirements.

You can also use Papersign (papersign.com) to collect eSignatures on consent forms, treatment agreements, or VNS programming authorization documents, keeping everything tied to the patient's submission for a complete audit trail.

Customization and scalability

Every epilepsy practice has its own protocols, preferred scales (e.g., Liverpool Seizure Severity Scale), and documentation requirements. Paperform's flexible editor makes it easy to:

  • Add validated seizure classification questions (focal vs. generalized, motor vs. non-motor)
  • Include standardized quality-of-life or seizure impact scales
  • Customize trigger checklists based on your patient population (pediatric triggers differ from adult triggers)
  • Add fields for ketogenic diet adherence, CBD use, or other adjunctive therapies your practice monitors

As your practice grows, you can create multiple versions of the form for different patient groups (pediatric vs. adult, VNS vs. RNS vs. medication-only) and manage them all from a single Paperform account with role-based access controls.

Get started in minutes

With 30,000+ designer templates and a no-code editor, your team can launch this epilepsy monitoring form today—no IT support or developer time required. Customize the questions, set up your email notifications and integrations, and share the form link via your patient portal, email campaigns, or telehealth platform.

Thousands of healthcare practices trust Paperform to handle patient intake, symptom tracking, consent collection, and care coordination. Whether you're a solo neurologist, a multi-site epilepsy center, or a telehealth startup, this Virtual Epilepsy Monitoring Form gives you a professional, scalable foundation for remote epilepsy care that works.

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raywhite.png
suncorp-logo-358x104.png
unesco.png
Bitmap.png
HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
Bitmap.png
HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
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