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BASELINE CONCUSSION ASSESSMENT Name Date of Birth / / School Sport(s) Previous Concussions? (circle one) NO or YES If yes, list how many and what years below Please score these symptoms based on how
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How to fill out baseline concussion assessment

How to fill out baseline concussion assessment
01
Start by gathering the necessary materials for the baseline concussion assessment, including a computer or tablet and the appropriate software.
02
Ensure that the athlete or individual being assessed is in a quiet and distraction-free environment.
03
Follow the instructions provided by the software to complete the various sections of the assessment, which may include questions about medical history, cognitive functioning, balance, and symptoms.
04
Ensure that the individual responds honestly and to the best of their abilities during the assessment.
05
Record and document the results of the assessment accurately and securely.
06
Baseline concussion assessments should be conducted by a qualified healthcare professional with expertise in concussion management.
Who needs baseline concussion assessment?
01
Baseline concussion assessments are typically recommended for athletes participating in contact and high-risk sports, such as football, hockey, soccer, and boxing.
02
Individuals who have a history of concussions or previous head injuries may also benefit from baseline assessments.
03
In certain occupations or activities that involve a higher risk of head injuries, such as military personnel or individuals involved in extreme sports, baseline concussion assessments may be necessary.
04
It is important to consult with a healthcare professional to determine if an individual is at risk for concussions and if they would benefit from a baseline assessment.
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What is baseline concussion assessment?
Baseline concussion assessment is a pre-season evaluation used to establish an athlete's normal cognitive and physical function in case of a concussion during the season.
Who is required to file baseline concussion assessment?
Athletes participating in contact sports are typically required to file baseline concussion assessment.
How to fill out baseline concussion assessment?
Baseline concussion assessment typically involves a series of questions, physical tests, and cognitive evaluations administered by a trained healthcare professional.
What is the purpose of baseline concussion assessment?
The purpose of baseline concussion assessment is to provide a reference point for comparison in case of a suspected concussion, helping healthcare providers make informed decisions about the athlete's return to play.
What information must be reported on baseline concussion assessment?
Baseline concussion assessment typically includes data on symptoms, medical history, cognitive function, and physical performance.
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