Get the free Concussion Information Sheet - North Thurston Public Schools

North Thurston Public Schools Concussion Information Sheet Definition A concussion is a brain injury that may be caused either by a direct blow to the head, face, neck or elsewhere on the body with

How to fill out concussion information sheet

How to fill out a concussion information sheet:

1. Gather personal information: Start by providing your name, date of birth, address, and contact information. This helps ensure that the information is accurate and up-to-date.
2. Provide medical history: Fill out details of any previous concussions or head injuries you have experienced. Include the date, cause, and severity of each incident. This information helps doctors assess your risk factors and make informed decisions regarding your care.
3. Describe current symptoms: Indicate any physical, cognitive, or emotional symptoms you are experiencing as a result of a recent head injury. This can include headaches, dizziness, memory problems, difficulty concentrating, or changes in mood or behavior.
4. List current medications: Include any medications you are currently taking, both prescription and over-the-counter. This information is crucial for doctors to avoid potential interactions or contraindications with any further treatment.
5. Provide contact information for emergency contacts: Include the names, phone numbers, and relationships of individuals who should be contacted in case of an emergency related to your head injury. This ensures that proper care can be administered promptly if needed.
6. Sign and date the form: At the end, there will typically be a section for you to sign and date the concussion information sheet. Your signature confirms that the information provided is accurate to the best of your knowledge.

Who needs a concussion information sheet?

1. Athletes: Individuals involved in contact or high-risk sports, such as football, hockey, or rugby, are often required to complete a concussion information sheet. This helps sports organizations monitor and manage head injuries among their athletes.
2. Students and parents: Schools may ask students and/or their parents to fill out a concussion information sheet as part of their medical records. This helps educators and healthcare providers understand any previous head injuries and potential risks for students.
3. Medical professionals: Doctors, nurses, and other healthcare providers may use concussion information sheets to gather complete and accurate information about a patient's head injury history, symptoms, and current condition. This aids in diagnosis, treatment planning, and ongoing care management.

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What is concussion information sheet?

Concussion information sheet is a document that provides information about concussions, including symptoms, treatment, and return-to-play guidelines.

Who is required to file concussion information sheet?

Coaches, athletes, and parents are required to file a concussion information sheet.

How to fill out concussion information sheet?

Concussion information sheet can be filled out by providing personal information, documenting any history of concussions, and acknowledging understanding of concussion protocols.

What is the purpose of concussion information sheet?

The purpose of concussion information sheet is to raise awareness about concussions, educate individuals on proper protocols, and ensure safety in sports.

What information must be reported on concussion information sheet?

Information such as personal details, medical history, concussion symptoms, and return-to-play guidelines must be reported on the concussion information sheet.