Get the free CJSA Concussion Notification Form - the Burlington Junior Soccer ...

Connecticut Junior Soccer Association Concussion Notification for CSA Events Today,2, at the insert name of event, insert players name received a possible concussion during practice or competition.

How to fill out cjsa concussion notification form

How to fill out CJSA concussion notification form:

1. Obtain the form: The CJSA concussion notification form can typically be obtained from your sports organization, coach, or team administrator. Make sure you have a copy of the most up-to-date version of the form.
2. Personal information: Fill in your personal information accurately in the designated fields. This may include your name, age, date of birth, address, and contact information. Ensure that you provide the necessary details as requested on the form.
3. Medical history: Provide information about your medical history, including any previous concussions or head injuries you may have experienced. Be honest and thorough when answering these questions as it is crucial for the safety of the athletes.
4. Current symptoms: Indicate any symptoms you are experiencing at the time of filling out the form. This may include headaches, dizziness, memory loss, or other signs of a possible concussion. Remember to be specific and provide as much detail as possible.
5. Healthcare provider information: Fill in the contact information of your healthcare provider who will be responsible for evaluating and treating your concussion. This may include their name, address, phone number, and any other relevant details.
6. Signature: Read the form carefully and sign it, indicating that you understand the risks associated with concussions and that you have provided accurate information to the best of your knowledge.
7. Submission: Submit the completed form to the appropriate person designated by your sports organization. This may be your coach, team administrator, or another designated individual responsible for collecting these forms.

Who needs CJSA concussion notification form:

1. Athletes: Any athlete participating in CJSA-sanctioned activities, such as soccer or other sports, may be required to fill out the CJSA concussion notification form. This form helps ensure the safety and well-being of the athletes by providing essential information about their medical history and current symptoms.
2. Parents or Legal Guardians: In the case of underage athletes, parents or legal guardians are typically responsible for filling out the CJSA concussion notification form on behalf of their child. It is crucial for them to be aware of any previous head injuries or symptoms experienced by their child.
3. Coaches and Team Administrators: These individuals may also need to familiarize themselves with the CJSA concussion notification form. They play an important role in ensuring that all athletes within their teams have submitted the required forms and that necessary precautions are taken in case of a suspected concussion.

Note: The specific requirements for filling out the CJSA concussion notification form may vary depending on the sports organization or local regulations. It is essential to follow the guidelines provided by the CJSA or your specific sports organization to ensure compliance and the safety of all participants.

For pdfFiller’s FAQs

What is cjsa concussion notification form?

CJSA concussion notification form is a form used to report concussions in youth athletes.

Who is required to file cjsa concussion notification form?

Coaches, parents, and medical professionals are required to file CJSA concussion notification form.

How to fill out cjsa concussion notification form?

CJSA concussion notification form can be filled out by providing the required information about the athlete, the injury, and the reporting party.

What is the purpose of cjsa concussion notification form?

The purpose of CJSA concussion notification form is to ensure that concussions in youth athletes are properly reported and managed.

What information must be reported on cjsa concussion notification form?

Information such as athlete's name, age, date of injury, symptoms, and contact information must be reported on CJSA concussion notification form.

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