HHS Concussion Signs and Symptoms Checklist 2010 free printable template
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See the section on Danger Signs on the back of this form. DIRECTIONS OBSERVED SIGNS MINUTES Use this checklist to monitor students who come to your o ce with a head injury. Concussion Signs and Symptoms Checklist Student s Name Student s Grade Date/Time of Injury Where and How Injury Occurred Be sure to include cause and force of the hit or blow to the head. Description of Injury concussions if any. Cdc.gov/Concussion. Irritable Sad More emotional than usual Nervous More Danger Signs...
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How to fill out HHS Concussion Signs and Symptoms Checklist
01
Obtain the HHS Concussion Signs and Symptoms Checklist from a reliable source.
02
Review the list of signs and symptoms related to concussions.
03
Ensure the individual being assessed is in a quiet environment for accurate evaluation.
04
Read each item on the checklist clearly to the individual.
05
Have the individual indicate whether they are experiencing each symptom by checking 'Yes' or 'No.'
06
Gather specific details about the onset and duration of any symptoms experienced.
07
Once completed, review the checklist for any concerning symptoms.
08
Store the completed checklist securely for future reference and further evaluation.
Who needs HHS Concussion Signs and Symptoms Checklist?
01
Athletes participating in sports with a risk of head injuries.
02
Coaches or trainers overseeing athletes in physical activities.
03
Parents or guardians of children engaging in contact sports.
04
Medical professionals conducting assessments after a suspected concussion.
05
School officials involved in student health and safety policies.
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What is HHS Concussion Signs and Symptoms Checklist?
The HHS Concussion Signs and Symptoms Checklist is a tool used to identify and document potential signs and symptoms of a concussion in individuals who have sustained a head injury.
Who is required to file HHS Concussion Signs and Symptoms Checklist?
Coaches, trainers, and healthcare professionals are required to file the HHS Concussion Signs and Symptoms Checklist for athletes who may have experienced a concussion.
How to fill out HHS Concussion Signs and Symptoms Checklist?
To fill out the HHS Concussion Signs and Symptoms Checklist, individuals should check off any observed signs or reported symptoms from the list and provide details about the incident and the athlete's condition.
What is the purpose of HHS Concussion Signs and Symptoms Checklist?
The purpose of the HHS Concussion Signs and Symptoms Checklist is to facilitate the identification of concussions and ensure that individuals receive timely medical evaluation and treatment.
What information must be reported on HHS Concussion Signs and Symptoms Checklist?
The information that must be reported includes the athlete's name, date of injury, specific signs and symptoms observed, and any actions taken following the incident.
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