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BELFAST HIGH SCHOOL CONCUSSION PROTOCOL Introduction Concussion can be described as a brain injury caused by either a direct blow to the head or where an impulsive force has been transmitted to the
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Obtain the concussion form from the school administration office or website.
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Read the form carefully to understand the information required and the process.
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Provide personal information such as name, date of birth, and contact details.
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Indicate the date and time of the injury or suspected concussion.
05
Describe the circumstances of the injury, including any specific events or activities involved.
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Provide details of any symptoms experienced after the injury, such as headache, dizziness, or confusion.
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If applicable, include information about any medical treatment received for the concussion.
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Sign and date the form to confirm that the provided information is accurate to the best of your knowledge.

Who needs Belfast High School concussion?

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Belfast High School students who have suffered a head injury or suspected concussion.
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Parents or legal guardians of Belfast High School students who have suffered a head injury.
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School staff, including teachers, coaches, and administrative personnel, who are responsible for reporting and managing concussions in students.
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Belfast High School concussion protocol is a set of guidelines and procedures to be followed when a student-athlete sustains a concussion while participating in school sports or activities.
The coaching staff, athletic trainers, and school administrators are required to file the Belfast High School concussion report.
The Belfast High School concussion report must be filled out with details of the student-athlete, the nature of the injury, and the steps taken for evaluation and treatment.
The purpose of the Belfast High School concussion protocol is to ensure the safety and well-being of student-athletes who may have sustained a concussion.
The information required to be reported on the Belfast High School concussion form includes the student-athlete's name, date of birth, sport/activity, date of injury, symptoms, and medical evaluation details.
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