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Lock port Elementary School District 91 808 Adams Street Lock port, Illinois 60441 Donna J. Gray, Superintendent RETURNTOLEARN AND RETURNTOPLAY CONSENT FORM For signature by parent/guardian before

How to fill out return-to-learn and return-to-play consent

How to fill out return-to-learn and return-to-play consent:

1. Start by stating the purpose of the consent form. Make sure to mention that it is necessary for individuals who have experienced a concussion or other head injury and are seeking to return to learning or playing sports.
2. Include sections for personal information, such as the individual's name, age, address, and contact information.
3. Ask for details about the specific injury, including the date it occurred and the symptoms experienced.
4. Include a section for medical history, where individuals can disclose any previous concussions or head injuries they have had.
5. Provide a section for healthcare provider information, where individuals can input the name, contact information, and credentials of the medical professional who has assessed their injury.
6. Include a section outlining the individual's agreement to follow all recommended treatment plans and return-to-learn or return-to-play protocols.
7. Request the signature of both the individual and their parent or guardian if applicable.
8. Provide space for the date of signing the consent form.

Who needs return-to-learn and return-to-play consent:

1. Athletes: Individuals who participate in sports or physical activities, and have suffered a concussion or head injury, require return-to-play consent. This consent form ensures that they have received appropriate medical care and are ready to resume playing.
2. Students: Individuals who have experienced a head injury and are returning to school need return-to-learn consent. This consent form helps ensure that the student can safely and effectively continue their education while recovering from the injury.
3. Parents or guardians: In cases where the individual seeking consent is a minor, their parent or guardian must provide consent on their behalf. This ensures that the individual's safety and well-being are considered throughout the return-to-learn and return-to-play process.

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What is return-to-learn and return-to-play consent?

Return-to-learn and return-to-play consent are forms required for students who have experienced a concussion to return to academic learning and physical activity.

Who is required to file return-to-learn and return-to-play consent?

Any student who has experienced a concussion and wants to return to academics or physical activities must file return-to-learn and return-to-play consent.

How to fill out return-to-learn and return-to-play consent?

Return-to-learn and return-to-play consent forms can typically be filled out by a parent or guardian of the student, in consultation with medical professionals.

What is the purpose of return-to-learn and return-to-play consent?

The purpose of return-to-learn and return-to-play consent is to ensure that students safely return to academic learning and physical activities after experiencing a concussion, following the appropriate protocols.

What information must be reported on return-to-learn and return-to-play consent?

Return-to-learn and return-to-play consent forms typically require information about the student's medical history, details of the concussion, and clearance from a healthcare provider.