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MSH SAA Concussion Return to Play Form
This form is adapted from the Acute Concussion Evaluation (ACE) care plan on the CDC website (www.cdc.gov/injury). All
medical providers are encouraged to review
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How to fill out mshsaa concussion return to
How to fill out mshsaa concussion return to
01
To fill out the MSHSAA concussion return to play form, follow these steps:
02
Obtain a copy of the form from your school or the MSHSAA website.
03
Fill out the student athlete's personal information, including name, date of birth, and contact information.
04
Provide details about the concussion, including the date of the injury and the symptoms experienced.
05
Include information about any medical evaluation or treatment received.
06
Fill in the specific steps taken for the student athlete's recovery, including any restrictions or modifications to their activities.
07
Note any medical clearance obtained and the date of clearance.
08
Have the student athlete and parent or guardian sign and date the form.
09
Submit the completed form to your school's athletic department or the appropriate authority.
Who needs mshsaa concussion return to?
01
Any student athlete who has suffered a concussion and wishes to return to sports or physical activities governed by MSHSAA regulations needs to fill out the MSHSAA concussion return to play form.
02
This form is required as part of the concussion management process to ensure a safe return to play for student athletes.
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What is mshsaa concussion return to?
MSHSAA concussion return to is a form that outlines the procedures and requirements for student-athletes to safely return to play after suffering a concussion.
Who is required to file mshsaa concussion return to?
School officials, coaches, and medical personnel are required to file MSHSAA concussion return to for student-athletes.
How to fill out mshsaa concussion return to?
To fill out MSHSAA concussion return to, the necessary information about the student-athlete's injury, treatment, and progression must be provided.
What is the purpose of mshsaa concussion return to?
The purpose of MSHSAA concussion return to is to ensure the safety and well-being of student-athletes by guiding them through a proper return-to-play protocol.
What information must be reported on mshsaa concussion return to?
Information such as the date of injury, symptoms experienced, medical evaluation results, and clearance from a healthcare provider must be reported on MSHSAA concussion return to.
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