Get the free 2016-17 Concussion Acknowledgement Statement (PDF)

StudentAthlete Concussion Statement Please initial all statements I understand that it is my responsibility to report all injuries and all illnesses to my Athletic Trainer and/or Team Physician. I

How to fill out 2016-17 concussion acknowledgement statement

How to fill out 2016-17 concussion acknowledgement statement:

1. Start by reading the entire statement carefully to understand its purpose and requirements.
2. Provide the necessary personal information, such as your full name, contact information, and any relevant identification numbers, as requested on the form.
3. Ensure to include the date of completion on the form as well.
4. Read each statement or question within the acknowledgement statement thoroughly before providing your response or checking the appropriate box.
5. Make sure to answer truthfully and accurately, as providing false information can have legal consequences.
6. If there is any section that you do not understand or are unsure about, seek clarification from the relevant authority before completing the form.
7. Once you have reviewed and filled out all the required sections, sign and date the form. Some forms may require additional signatures, such as those of parents or guardians for minors.
8. Keep a copy of the completed and signed form for your records, and submit the original form to the appropriate organization or individual as instructed.

Who needs 2016-17 concussion acknowledgement statement:

1. Student athletes: Many educational institutions and sports organizations require student athletes to fill out a concussion acknowledgement statement. This ensures that they and their parents or guardians understand the potential risks and symptoms of concussions and that they have received proper education about them.
2. Coaches and volunteers: Coaches, trainers, and other individuals involved in organizing or supervising athletic activities may also be required to complete a concussion acknowledgement statement. This demonstrates their commitment to player safety and their understanding of the necessary protocols in case of a concussion.
3. Parents or guardians: In some cases, parents or guardians are required to sign a concussion acknowledgement statement to acknowledge that they have received the necessary information and understand the risks associated with their child's participation in sports.

Remember, the specific requirements for who needs a 2016-17 concussion acknowledgement statement may vary depending on the organization, educational institution, or sports league. It is essential to consult the relevant policies or guidelines to ensure compliance.

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What is 17 concussion acknowledgement statement?

17 concussion acknowledgement statement is a document that acknowledges the risk of concussion in certain activities.

Who is required to file 17 concussion acknowledgement statement?

Any individual participating in activities that have a risk of concussion is required to file the 17 concussion acknowledgement statement.

How to fill out 17 concussion acknowledgement statement?

To fill out the 17 concussion acknowledgement statement, one must provide their personal information, acknowledge the risk of concussion, and sign the document.

What is the purpose of 17 concussion acknowledgement statement?

The purpose of the 17 concussion acknowledgement statement is to ensure that individuals are aware of the risks associated with activities that could result in concussion.

What information must be reported on 17 concussion acknowledgement statement?

The 17 concussion acknowledgement statement must include personal information of the individual, acknowledgment of the risk of concussion, and signature.