Get the free Baseline Concussion Testing Registration Form

This document outlines the details for Baseline Concussion Testing offered by the Marlboro Soccer Association in collaboration with db Orthopedic Physical Therapy, aimed at establishing cognitive

How to fill out baseline concussion testing registration

How to fill out Baseline Concussion Testing Registration Form

1. Obtain the Baseline Concussion Testing Registration Form from your designated health or sports organization.
2. Fill in your personal information, including your full name, date of birth, and contact details.
3. Provide any relevant medical history related to concussions or head injuries, if applicable.
4. Complete the section regarding emergency contact information.
5. Sign and date the form to indicate your consent for testing and that all information provided is accurate.
6. Submit the completed form to the authorized personnel or organization managing the concussion testing.

Who needs Baseline Concussion Testing Registration Form?

1. Athletes participating in contact sports to assess their baseline cognitive function before potential head injuries.
2. Coaches and trainers requiring a baseline for injury management and decision-making.
3. Parents or guardians of young athletes whose children will participate in sports with a risk of concussion.

People Also Ask about

Is baseline concussion testing necessary?

Baseline Concussion testing is a crucial pre-injury assessment tool for athletes, evaluating their cognitive abilities and other neurological functions. This assessment, conducted before any potential head trauma, establishes a benchmark for comparison in the event of a concussion.

What does baseline++ mean on a concussion test?

“Baseline++” is what we refer to as an invalid test. Some common reasons a test taker may receive an invalid test include not understanding the instructions, not taking the test in their native language, or not giving their full effort.

How to do a baseline concussion test?

You take the test on a computer, and it takes about 20 minutes. ImPACT tests your verbal and visual memory and your brain processing and reaction time. At the end of the test, you get a score. ImPACT doesn't diagnose a concussion.

What does baseline mean in a concussion test?

Having a baseline assessment, that is, knowing how the athlete's brain was functioning before the concussion would be an ideal way to assess whether their NPT testing after injury is normal.

How do you perform a basic concussion test?

One simple concussion assessment test is to shine a low-beam flashlight from the outer edge of each eye inward. Pupils should quickly get smaller (constrict) in response to the light. A slow pupil response to light may be a sign of brain injury (increased intracranial pressure or ICP).

What is the difference between a baseline concussion test and a post-concussion test?

Baseline testing measures your brain function in a normal, healthy state — before a concussion occurs. If you happen to suffer a concussion, doctors will test you again and use your scores to help decide: What type of concussion you may have.

How long does baseline concussion testing take?

If you take the test now, before a concussion, you will have a baseline score to compare against if you do get a concussion. The baseline test can be taken at home on a computer (unfortunately not on a smartphone or tablet) and takes about 30 minutes in a quiet room.

For pdfFiller’s FAQs

What is Baseline Concussion Testing Registration Form?

The Baseline Concussion Testing Registration Form is a document used to collect and record a student's baseline cognitive function before participating in sports, helping in the assessment of potential concussions.

Who is required to file Baseline Concussion Testing Registration Form?

Typically, students participating in contact sports or high-risk sports are required to file the Baseline Concussion Testing Registration Form, along with their parents or guardians.

How to fill out Baseline Concussion Testing Registration Form?

To fill out the Baseline Concussion Testing Registration Form, individuals need to provide personal information such as name, age, contact details, and medical history related to concussions, as well as obtaining consent from a parent or guardian.

What is the purpose of Baseline Concussion Testing Registration Form?

The purpose of the Baseline Concussion Testing Registration Form is to establish a reference point for an athlete's cognitive functions, aiding medical professionals in evaluating potential concussion-related impairments.

What information must be reported on Baseline Concussion Testing Registration Form?

The information that must be reported on the Baseline Concussion Testing Registration Form typically includes the athlete's personal details, medical history related to previous concussions, emergency contact information, and parental consent.