Vanderbilt University Concussion Excuse Form free printable template

Vanderbilt Sports Medicine Patient: Date: Please excuse the above named patient from school today due to a medical appointment. The student has sustained a concussion and is currently under the care

How to fill out concussion vanderbilt head form

How to fill out Vanderbilt University Concussion Excuse Form

1. Obtain the Vanderbilt University Concussion Excuse Form from the university's official website or the athletic department.
2. Fill in the student's name, date of birth, and contact information at the top of the form.
3. Provide the date of the concussion incident and any relevant details about how it occurred.
4. Include the name and contact information of the healthcare provider who assessed the concussion.
5. Indicate the symptoms experienced by the student and any treatments administered.
6. Sign and date the form to confirm the information is accurate.
7. Submit the completed form to the appropriate university office, such as the health services or athletic department.

Who needs Vanderbilt University Concussion Excuse Form?

1. Students who have sustained a concussion while participating in sports or other activities.
2. Athletes required to provide documentation for missed classes or competitions due to a concussion.
3. Any student who has been evaluated by a healthcare professional for a concussion and needs to formally excuse their absence.

People Also Ask about coordinator concussion document

When can you return to play after a concussion?

Our providers typically consider clearance once the athlete is: Free of concussion symptoms for at least 24 hours. Off any medications started for concussion symptoms. Attending full days of school and tolerating a full academic workload (if applicable, depending on the time of year)

What is concussion protocol for college athletes?

Each NCAA student-athlete with concussion must undergo a supervised stepwise progression* management plan by a health care provider with expertise in concussion that specifies: Symptom-limited activity. Light aerobic exercise without resistance training. Sport-specific exercise and activity without head impact.

What is the concussion protocol for high school?

This may include staying home from school during the short period of rest (typically no more than 1-2 days) followed by a lighter school schedule for a few days, or longer, if necessary. Decreasing the stress to the brain in the early phase after a concussion may lessen symptoms and shorten the recovery time.

What are the steps in the return to play protocol for concussion?

6-Step Return to Play Progression Step 1: Back to regular activities (such as school) Athlete is back to their regular activities (such as school). Step 2: Light aerobic activity. Step 3: Moderate activity. Step 4: Heavy, non-contact activity. Step 5: Practice & full contact. Step 6: Competition.

What is the return to school protocol for a concussion?

Immediately after a concussion, it is beneficial to take a break from cognitive (thinking, processing) activities for up to a few days. This may mean no school, no homework, no computer, no texting, no video games and maybe no TV if it makes symptoms worse. In general, it is beneficial to minimize screen time.

What is the concussion return to play protocol Nchsaa?

1. No athlete with a suspected concussion is allowed return to practice or play the same day that his or her head injury occurred. 2. Athletes should never return to play or practice if they still have ANY symptoms.

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What is Vanderbilt University Concussion Excuse Form?

The Vanderbilt University Concussion Excuse Form is a document used to formally excuse a student-athlete from participation in sports or other activities due to a concussion diagnosis.

Who is required to file Vanderbilt University Concussion Excuse Form?

The form must be filed by student-athletes who have been diagnosed with a concussion, and it is typically completed by a healthcare professional.

How to fill out Vanderbilt University Concussion Excuse Form?

To fill out the form, a healthcare provider must provide their details, confirm the concussion diagnosis, recommend a return-to-play protocol, and sign the document.

What is the purpose of Vanderbilt University Concussion Excuse Form?

The purpose of the form is to ensure the health and safety of student-athletes by formally documenting their concussion status and outlining necessary precautions before returning to activities.

What information must be reported on Vanderbilt University Concussion Excuse Form?

The information required includes the date of the concussion, symptoms reported, medical evaluation details, healthcare provider’s signature, and a recommended timeline for returning to play.