Get the free Concussion Information Sheet - Orting School District 344 - ortingschools

Concussion Information Sheet A concussion is a brain injury and all brain injuries are serious. They are caused by a bump, blow, or jolt to the head, or by a blow to another part of the body with

How to fill out concussion information sheet

Who needs a concussion information sheet?

1. Athletes: In any sports or physical activities where there is a risk of head injury, athletes should be provided with a concussion information sheet. This includes individuals participating in football, soccer, basketball, hockey, boxing, and other high-impact sports.
2. Coaches and trainers: It is essential for coaches and trainers to have access to concussion information sheets to educate athletes about the risks, signs, and symptoms of concussions. Coaches and trainers should know how to properly fill out the sheet to ensure accurate information.
3. Medical professionals: Doctors, nurses, and other medical professionals who are involved in the diagnosis and treatment of concussions also need access to this information. They utilize it to understand the circumstances surrounding the injury and provide appropriate care to the injured individuals.

How to fill out a concussion information sheet:

1. Personal details: Begin by entering the individual's personal information, such as their full name, date of birth, address, and contact information. This is important for identification and communication purposes.
2. Injury details: Provide a detailed account of how and when the head injury occurred. Include information about the specific sport, activity, or incident that led to the concussion. Be as specific as possible to help healthcare professionals assess the severity and potential causes of the injury.
3. Symptoms: List all the symptoms experienced by the individual after the head injury. These can include headache, dizziness, nausea, memory loss, blurred vision, sensitivity to light or noise, difficulty concentrating, and mood changes. It is crucial to accurately identify and describe all symptoms to aid in diagnosis and appropriate treatment.
4. Immediate actions taken: Describe the initial actions taken immediately after the injury. This may include staying on the field, receiving on-site medical attention, or being transported to a hospital. These details provide valuable context for medical professionals.
5. Previous concussions and medical history: Include information about any previous head injuries or concussions the individual has had. Additionally, provide details of any existing medical conditions or medications that may be relevant to the injury or recovery process.
6. Follow-up and treatment: Outline any follow-up appointments or medical treatments that have occurred or are planned. For example, note if the individual has seen a doctor, visited a specialist, or undergone any diagnostic tests like CT scans. This helps medical professionals understand the level of care the individual has received.
7. Return to play: If the person filling out the form is a coach or trainer, it is crucial to document any restrictions or recommendations for the individual's safe return to activity. This may include suggestions for modified training or temporary restrictions from participation until cleared by a healthcare professional.
8. Signature and contact information: The person completing the concussion information sheet should sign and provide their contact information. This allows for easy communication and follow-up, if necessary.

Remember, it is essential to consult specific guidelines provided by medical professionals, sports organizations, or educational institutions when filling out a concussion information sheet to ensure accuracy and consistency.

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What is concussion information sheet?

Concussion information sheet is a document that provides information about concussions, their symptoms, and how to properly manage them.

Who is required to file concussion information sheet?

Coaches, parents, and athletes are required to file concussion information sheet.

How to fill out concussion information sheet?

Concussion information sheet can be filled out by providing personal information, detailing any history of concussions, and acknowledging understanding of concussion protocols.

What is the purpose of concussion information sheet?

The purpose of concussion information sheet is to increase awareness about concussions, educate individuals on how to recognize and respond to them, and promote safety in sports.

What information must be reported on concussion information sheet?

Information such as name, contact information, medical history, any previous concussions, and acknowledgment of understanding of concussion protocols must be reported on concussion information sheet.