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Belmont Middle School 1200 North Adams Drive Decatur, Indiana 46733 Phone: 260.724.3137 Fax: 260.724.4495 Scott A. Miller, Principal Timothy L. Myers, Assistant Principal/Athletic Director Jeffrey
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Describe the symptoms you experienced during the incident. Include details such as headache, dizziness, confusion, loss of consciousness, memory problems, etc.
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If you sought medical attention, provide the name of the healthcare professional or facility you visited and any diagnosis or recommended treatments provided.
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Head concussion is a type of traumatic brain injury caused by a sudden blow to the head. Sudden refers to the unexpected or abrupt nature of the event.
Healthcare providers and organizations are required to file head concussion and sudden reports.
Head concussion and sudden reports can be filled out electronically or on paper forms provided by the relevant authorities.
The purpose of head concussion and sudden reports is to monitor and track traumatic brain injuries to improve prevention and treatment strategies.
Information such as patient demographics, date of injury, cause of injury, symptoms, and treatment received must be reported on head concussion and sudden forms.
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