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SACK SCHOOLS CONCUSSION INFORMATION SHEET What can happen if my child keeps on playing with a concussion or returns too soon? Athletes with the signs and symptoms of concussion should be removed from

How to fill out concussion information sheet

How to fill out a concussion information sheet?

1. Start by providing personal information: Write your full name, date of birth, address, and contact details such as phone number and email address.
2. Mention any relevant medical history: Fill in any pre-existing medical conditions, previous concussions, or other head injuries that you have experienced.
3. Include information about the incident: Describe how the concussion occurred, whether it was due to a specific accident or trauma, the date and time it happened, and where it occurred.
4. Provide details about symptoms: List any symptoms you experienced immediately after the incident, such as headache, dizziness, nausea, memory loss, confusion, or sensitivity to light and sound.
5. Mention any ongoing symptoms: If you are still experiencing symptoms at the time of filling out the form, indicate what symptoms you are currently facing and their severity.
6. Note any medical treatment received: If you sought medical attention for your concussion, provide the name of the healthcare provider, their contact information, and any treatment received or recommended.
7. Include details of any medications taken: List any prescribed or over-the-counter medications you are currently taking or were prescribed for the concussion.
8. Answer questions about your return to activities: The concussion information sheet may include questions about your ability to perform daily activities, work, or participate in sports or physical exercises.

Who needs a concussion information sheet?

1. Athletes: Concussion information sheets are often required for athletes participating in sports organizations or events. This helps ensure that any head injuries are properly documented and managed.
2. Students: Schools may require students to fill out concussion information sheets, especially if they are participating in physical education classes, sports activities, or extracurricular sports teams.
3. Employees: Some workplaces, particularly those that involve physical labor, may request employees to complete concussion information sheets to have a record of any workplace-related head injuries.
4. Medical professionals: Healthcare providers may also use concussion information sheets to gather relevant information about a patient's concussion history, symptoms, and treatment in order to provide appropriate care and advice.

Remember, it is important to consult with a healthcare professional if you have experienced a concussion or suspect you may have one.

For pdfFiller’s FAQs

What is concussion information sheet?

Concussion information sheet is a document that provides information about concussions, including symptoms, treatment, and recovery.

Who is required to file concussion information sheet?

Coaches, trainers, and officials are required to file concussion information sheet.

How to fill out concussion information sheet?

Concussion information sheet can be filled out by providing relevant information about the individual's symptoms, medical history, and any previous concussions.

What is the purpose of concussion information sheet?

The purpose of concussion information sheet is to ensure that individuals are aware of the risks and proper protocols associated with concussions.

What information must be reported on concussion information sheet?

Information such as symptoms, medical history, and previous concussions must be reported on concussion information sheet.

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