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My Family Is Living with a Rare Epilepsy Form

Explain your family’s needs to teachers, coaches, and others in your child’s support circle.

Adapted from the VIP Sibling Project form for teachers, coaches, and other trusted people. Rare epilepsy can interrupt routines, sleep, attendance, and concentration. Use this page to explain your family’s circumstances and share the support your child needs.

Save your changes to review or print this worksheet. Entries stay on this device and are not submitted to the Foundation.

Our family
Our family’s emergency arrangements
My contact information
If I cannot be reached

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Original downloads

Open the official resource to read, download, or print it. Spanish materials remain in their original format.

Opens vipsibling.com in a new tab. Original materials from the VIP Sibling Project, ©2024 UCB, Inc., unless otherwise noted in the resource.

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