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KANSAS RECOMMENDED CONCUSSION & HEAD INJURY INFORMATION RELEASE FORM 20152016 This form must be signed by all student athletes and parent/guardians before the student participates in any athletic
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How to fill out concussion form 15-16

How to fill out concussion form 15-16:
01
Obtain the concussion form 15-16 from the appropriate source, such as a school or sports organization.
02
Read the instructions and familiarize yourself with the purpose and requirements of the form.
03
Begin by providing your personal information, including your full name, date of birth, and contact information.
04
Next, provide any relevant medical information, such as previous concussions or medical conditions that may affect the evaluation.
05
Indicate the date and time of the concussion incident, as well as the sport or activity in which it occurred.
06
Describe the symptoms experienced after the concussion, including headache, dizziness, nausea, or memory loss.
07
Provide information about any medical evaluations or treatments received following the concussion, including the healthcare professional's name and contact details.
08
If applicable, indicate any time away from school or sports activities due to the concussion.
09
Lastly, sign and date the form to certify the accuracy of the information provided.
Who needs concussion form 15-16:
01
Athletes participating in school or organized sports activities.
02
Students involved in physical education programs.
03
Individuals who have experienced a concussion or suspected concussion during sports or other activities that require evaluation and documentation.
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What is concussion form 15-16?
Concussion form 15-16 is a document used to report incidents of concussion that occurred during the period of 2015-2016.
Who is required to file concussion form 15-16?
All schools, sports organizations, and medical professionals involved in youth sports are required to file concussion form 15-16.
How to fill out concussion form 15-16?
Concussion form 15-16 should be filled out by providing necessary information such as the details of the concussion incident, the affected individual's information, and any medical treatment administered.
What is the purpose of concussion form 15-16?
The purpose of concussion form 15-16 is to track and report instances of concussions in youth sports and ensure appropriate medical treatment and follow-up.
What information must be reported on concussion form 15-16?
Concussion form 15-16 requires reporting of the date and location of the concussion incident, details of the affected individual, symptoms experienced, medical treatment provided, and any subsequent follow-up care.
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