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2017 2018CONCUSSION AND HEAD INJURY MEDICAL CLEARANCE PART 1 (COMPLETED BY A PARENT OR LEGAL GUARDIAN) LAST NAMEFIRST NAMEBIRTHDATESTUDENT ID NUMBER1. Date of last complete physical examination: Performing
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Begin by assessing the situation and determining if the person is conscious and breathing. Call emergency services if necessary.
02
Keep the person still and encourage them to avoid moving their head or neck.
03
If the person is wearing a helmet, do not remove it unless it restricts their breathing.
04
Check for any signs of a head injury, such as bleeding, bruising, or deformity. If present, apply gentle pressure using a clean cloth to control bleeding.
05
Encourage the person to lie down and elevate their head slightly. This can help reduce swelling.
06
If the person is experiencing nausea or vomiting, turn them on their side to prevent choking.
07
Stay with the person until medical help arrives, monitoring their condition and providing reassurance.
08
Do not give the person any medication unless directed by a healthcare professional.
09
After medical attention, follow any specific instructions provided by the healthcare provider for further care and monitoring.

Who needs concussion and head injury?

01
Anyone who has experienced a head injury or concussion may need medical attention or assessment.
02
This can include individuals involved in high-impact sports or activities, individuals who have been in accidents or falls, or those who exhibit symptoms of a head injury like loss of consciousness, confusion, severe headache, dizziness, or vomiting.
03
It is important to seek medical attention to ensure proper diagnosis and appropriate treatment.
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Concussion is a mild traumatic brain injury that occurs after a blow to the head. Head injury refers to any trauma or injury to the head.
Healthcare providers, coaches, trainers, and school officials are required to file concussion and head injury reports.
Concussion and head injury reports can be filled out by providing detailed information about the injury, symptoms, and treatment received.
The purpose of reporting concussion and head injury is to track and monitor these injuries, ensure proper treatment, and prevent future incidents.
Information such as the date of the injury, symptoms experienced, treatment received, and follow-up care must be reported on concussion and head injury forms.
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