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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

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.
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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.
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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.
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Individuals who have a history of concussions or previous head injuries may also benefit from baseline assessments.
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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.
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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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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.
Athletes participating in contact sports are typically required to file baseline concussion assessment.
Baseline concussion assessment typically involves a series of questions, physical tests, and cognitive evaluations administered by a trained healthcare professional.
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.
Baseline concussion assessment typically includes data on symptoms, medical history, cognitive function, and physical performance.
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