Get the free CONCUSSION RETURN TO PLAY FORM - Longmont Baseball

CONCUSSION RETURN TO PLAY FORM This form is adapted from the Acute Concussion Evaluation (ACE) care plan on the CDC website (www.cdc.gov/injury). All medical providers are encouraged to review this

How to fill out concussion return to play

How to fill out concussion return to play:

1. Obtain necessary forms: Start by obtaining the concussion return to play forms from the appropriate authorities. This may include forms from medical professionals, coaches, or athletic trainers.
2. Provide personal information: Fill out the necessary personal information on the forms, such as name, date of birth, address, and contact details. Ensure all information is accurate and up to date.
3. Medical history: Provide details about your medical history, including any previous concussions, past injuries, or relevant medical conditions. This information is crucial for healthcare professionals to assess your situation accurately.
4. Incident details: Describe the concussion incident in as much detail as possible. Include the date, time, location, and any relevant circumstances surrounding the injury. The more information provided, the better understanding healthcare professionals will have of the incident.
5. Symptoms and recovery: Outline the symptoms experienced since the concussion, both immediately after and during the recovery process. Be thorough in describing any physical, cognitive, or emotional symptoms to ensure proper evaluation and treatment can be provided.
6. Medical evaluation: Fill out information regarding the medical evaluation conducted by healthcare professionals. This may include details about the evaluation date, findings, diagnosis, and recommendations for treatment and recovery.
7. Return to play progression: Provide information about the process of returning to physical activity after the concussion. This may involve different stages or steps outlined by medical professionals, including gradual increases in activity levels, cognitive exertion, and contact sports participation.

Who needs concussion return to play:

1. Athletes: Concussion return to play protocols are primarily designed for athletes who have suffered a concussion. This includes individuals participating in contact sports such as football, hockey, soccer, or basketball. Additionally, athletes involved in non-contact sports like gymnastics or cheerleading may also require concussion return to play assessments.
2. Students: Students who have experienced a concussion, whether through sporting activities or other accidents, may also need to go through the concussion return to play process before resuming physical education classes or participating in other school-based physical activities.
3. Recreational enthusiasts: Individuals involved in recreational activities such as recreational leagues, fitness classes, or individual sports activities should also adhere to concussion return to play guidelines if they sustain a concussion. This ensures their safety and helps prevent further injury during physical exertion.
4. Military personnel: Members of the military who sustain concussions during training exercises, combat situations, or other military activities also need to follow concussion return to play protocols. These protocols help ensure their safe return to duty and minimize the risk of exacerbating their conditions.

Remember, it is essential to consult with a healthcare professional, such as a physician or athletic trainer, for specific guidance tailored to your individual circumstances when filling out concussion return to play forms and determining the appropriate course of action.

For pdfFiller’s FAQs

What is concussion return to play?

Concussion return to play is a protocol designed to ensure the safe return of athletes to sports activities after experiencing a concussion.

Who is required to file concussion return to play?

Athletes who have suffered a concussion and want to return to the sports activities are required to file concussion return to play.

How to fill out concussion return to play?

To fill out a concussion return to play form, the athlete must provide information about their concussion symptoms, medical treatment received, and clearance from a healthcare provider.

What is the purpose of concussion return to play?

The purpose of concussion return to play is to protect the health and safety of athletes by ensuring they are fully recovered and medically cleared before returning to sports activities.

What information must be reported on concussion return to play?

Information such as the date of injury, symptoms experienced, medical treatment received, clearance from a healthcare provider, and any relevant medical history must be reported on concussion return to play.

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