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CONCUSSION FACT SHEET WHAT IS A CONCUSSION? A concussion is a brain injury, and is caused by a bump or blow to the head OR body. Even a ding or what seems to be a mild bump can be serious. You cannot

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How to fill out concussion fact sheet

01

Begin by gathering all relevant information before starting to fill out the concussion fact sheet. This may include the individual's name, date of birth, contact information, and any other necessary details.

02

The concussion fact sheet should typically include sections for personal information, medical history, symptoms, and any previous concussions or head injuries. Fill out each section accurately and thoroughly.

03

In the personal information section, provide the individual's full name, address, phone number, and emergency contact details. This will help ensure proper communication and care in case of an emergency.

04

The medical history section should include any pre-existing medical conditions, medications currently being taken, or allergies that the individual may have. It is important to disclose all relevant information to assist healthcare professionals in providing appropriate care.

05

The symptoms section should list any symptoms experienced as a result of the concussion or head injury. This may include headaches, dizziness, memory problems, nausea, sensitivity to light or noise, or any other symptoms that have been noticed. Be as detailed as possible in describing these symptoms.

06

Indicate any previous concussions or head injuries in the designated section. Provide information about when the injuries occurred, how they were acquired, and any medical treatment received at the time.

07

It is crucial to answer all questions on the concussion fact sheet honestly and accurately. Providing misleading or incomplete information could hinder proper assessment and care.

08

Remember that the concussion fact sheet may be required by various individuals involved in the care and treatment of the individual, including doctors, coaches, athletic trainers, or school administrators.

09

Any individual who has experienced a concussion or head injury should have a concussion fact sheet filled out. This includes athletes participating in sports, individuals involved in accidents or falls, or anyone who has encountered a blow to the head resulting in concussion-like symptoms.

10

Additionally, healthcare professionals may also complete a concussion fact sheet for patients to thoroughly document their medical history and identify any potential risk factors or recurring injuries.

By following these guidelines, you can ensure that the concussion fact sheet is completed accurately and comprehensively, aiding in the proper assessment and care of individuals who have experienced a concussion or head injury.

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What is concussion fact sheet?

Concussion fact sheet is a document that provides information about concussions, including symptoms, treatments, and preventative measures.

Who is required to file concussion fact sheet?

Schools, sports organizations, and healthcare providers are required to file concussion fact sheets.

How to fill out concussion fact sheet?

Concussion fact sheets can be filled out by providing information on the individual who experienced the concussion, the date and location of the injury, symptoms experienced, and any treatment received.

What is the purpose of concussion fact sheet?

The purpose of concussion fact sheet is to track and report incidents of concussions to help improve awareness and prevention efforts.

What information must be reported on concussion fact sheet?

Information such as the individual's name, age, date of injury, symptoms experienced, treatment received, and any follow-up care needed must be reported on concussion fact sheet.

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