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Quick Talker 12Long Range Pendant & Pager Kit

Epilepsy & Seizure Evaluation Form

Price per Unit (piece): Call for Pricing

Ask a question about this product

 Epileptic Nocturnal Seizure Detection Monitor Evaluation

Call us on 1890 344 344 and we can email or post the form to you  

Or Copy text below and email it back to us with the questions filled in to

All information recieved is confidential
 Before Purchasing we ask you to fill out answers for the questions below so we can get the right monitor for you.
  • Patient reference: 
  • Date  (                          )
  • What is the age of the patient?   (                 )
  • What is the weight of the patient?    (                   )
  • Has the patient been diagnosed with epilepsy?     (                )
  • Does the patient have learning disabilities?  (         )
  • Does the patient have any other medical conditions?  (                                                              )
  • Are there any reference records of seizure activity?  (                
  • Does the patient experience Tonic/Clonic seizures?     (                )
  • Does the patient experience limb movement during a seizure?  (whole body shaking, arms and or legs moving).       (              )
  • How long do the seizures typically last?          (                    )
  • Does the patient vocalize preceding or during a seizure?    (                    )
  • If a radio link alarm is to be used, a pager for example, what is the maximum distance the pager could be away from the monitor?   (                 )
  • Are any other types of monitors used with the patient, a baby monitor, heart or respiration monitor? (                                                                                                                                                )
  • What type of bed does the patient sleep on?  Please describe the bed in detail (single, double, king-size, solid bed base, slatted base, profiling) including the type and size of mattress (if a sprung type, memory foam, pressure relieving etc.).   (                                                                                                                               )

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Lo Call 1890 344 344

Outside Ireland Call

(00)353 214 214 925


  Healthcare Communications


For all Nursing Home

& Hospital Enquiries 


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