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Concussion Information Sheet A concussion is a brain injury and all brain injuries are serious. They are caused by a bump, blow, or jolt to the head, or by a blow to another part of the body with

How to fill out concussion information sheet and

How to fill out a concussion information sheet:

1. Start by carefully reading the instructions on the sheet. Understand the purpose and importance of providing accurate information.
2. Begin by filling out your personal details such as your name, date of birth, and contact information. Ensure that all the information provided is correct.
3. Moving on, provide information about the circumstances of the concussion. Include details about when and where the concussion occurred, as well as any activities or sports involved.
4. Mention any symptoms experienced after the concussion, such as headaches, dizziness, memory problems, or changes in behavior. Be as specific as possible and include the duration and severity of each symptom.
5. If you sought medical attention, provide details about the healthcare professional or facility that provided the initial diagnosis and treatment.
6. Include information about any previous concussions or head injuries, even if they occurred years ago. This will help healthcare providers evaluate the severity and potential long-term effects of the current concussion.
7. Lastly, sign and date the concussion information sheet to confirm that all the information provided is accurate to the best of your knowledge.

Who needs a concussion information sheet:

1. Athletes: Individuals participating in sports, especially contact sports like football, hockey, rugby, or soccer, should fill out a concussion information sheet. This helps ensure that proper medical attention and care can be provided in case of a concussion.
2. Parents or guardians: If the person involved is a minor, their parents or guardians should fill out the concussion information sheet. This ensures that accurate information is available to medical professionals in case of a concussion.
3. Coaches and team officials: It is important for coaches and team officials to have access to concussion information sheets for all their athletes. This enables them to be aware of any previous head injuries and monitor athletes for potential concussions during games and practices.

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