Get the free Concussion Information Form - Francis Parker School - francisparker

FRANCIS PARKER SCHOOL 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

How to fill out concussion information form

1. To fill out a concussion information form, start by obtaining the necessary form from your physician, school, or sports organization.
2. Read the instructions on the form carefully to understand what information is required and how to properly complete it.
3. Begin by providing your personal details, such as your name, contact information, date of birth, and any relevant identification numbers.
4. Next, you may be asked to provide information about your medical history, including any previous head injuries, concussions, or related symptoms.
5. It's important to be as accurate and detailed as possible when describing your symptoms, the circumstances of the injury, and any treatment received.
6. If there are specific questions asking about your symptoms, rate their severity or frequency using the scale provided.
7. You may also be asked to provide information about any previous baseline testing or medical evaluations related to concussions.
8. Sign and date the form to confirm that the information provided is true and accurate to the best of your knowledge.
9. Keep a copy of the completed form for your records, and submit any necessary copies to the appropriate individuals or organizations.

Who needs a concussion information form?

1. Athletes: Sports organizations typically require athletes to complete a concussion information form before participating in practices or competitions. This is done to ensure the safety of the participants and to have a record of any previous head injuries or symptoms.
2. Students: Schools may also require students to fill out a concussion information form, especially if they participate in physical education classes, sports, or other activities that could potentially involve a risk of head injury.
3. Employees: Some workplaces, particularly those in industries where head injuries are more likely to occur, may also require employees to fill out a concussion information form. This helps employers assess the risk and provide appropriate support and resources for anyone who may have experienced a concussion.

For pdfFiller’s FAQs

What is concussion information form?

Concussion information form is a document used to report any incidents or suspicions of concussions in sports or physical activities.

Who is required to file concussion information form?

Coaches, athletic trainers, and medical personnel are typically required to file the concussion information form.

How to fill out concussion information form?

The form should be filled out with details of the incident, symptoms observed, and any actions taken. It may also require signatures of involved parties.

What is the purpose of concussion information form?

The purpose of the concussion information form is to ensure proper reporting and documentation of any concussions to protect the health and safety of athletes.

What information must be reported on concussion information form?

Information such as date of incident, symptoms observed, actions taken, and follow-up protocols must be reported on the concussion information form.

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