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Ohio Department of Health Concussion Information Sheet
For Interscholastic Athletics
Dear Parent/Guardian and Athletes,
This information sheet is provided to assist you and your child in recognizing
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How to fill out concussion information sheet

How to fill out concussion information sheet
01
Step 1: Start by gathering all necessary information, such as the personal details of the individual experiencing the concussion, including their name, age, and contact information.
02
Step 2: Provide a detailed account of how the concussion occurred, including the date, time, and location of the incident.
03
Step 3: Document any immediate symptoms or signs of a concussion that were observed, such as loss of consciousness, confusion, dizziness, headache, or nausea.
04
Step 4: Note down any medical interventions or treatments provided at the scene or afterwards, including first aid, hospital visits, or medication.
05
Step 5: Include information about any previously diagnosed concussions or head injuries, as well as any relevant medical history.
06
Step 6: If applicable, record details about any witnesses present during the concussion incident, including their names and contact information.
07
Step 7: Make sure to sign and date the concussion information sheet, indicating that the information provided is accurate and complete.
08
Step 8: Submit the filled-out concussion information sheet to the appropriate authority or medical professional for further evaluation and documentation.
Who needs concussion information sheet?
01
Anyone who has experienced a concussion or suspects that they may have suffered a head injury needs a concussion information sheet.
02
Medical professionals, including doctors, nurses, and athletic trainers, may also require a concussion information sheet to assess and monitor the patient's condition.
03
Schools, sports organizations, and workplaces often request a concussion information sheet to ensure appropriate care and support can be provided in case of a concussion.
04
Parents or legal guardians of minors who have had a head injury should also fill out a concussion information sheet for accurate record-keeping and communication with healthcare providers.
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What is concussion information sheet?
Concussion information sheet is a document that provides important details about concussions, including symptoms, treatment, and prevention.
Who is required to file concussion information sheet?
Concussion information sheet is required to be filed by schools, sports organizations, and healthcare providers.
How to fill out concussion information sheet?
Concussion information sheet can be filled out by providing accurate and up-to-date information about concussions, including any incidents or diagnoses.
What is the purpose of concussion information sheet?
The purpose of concussion information sheet is to help educate individuals about concussions, promote safety measures, and provide resources for those affected.
What information must be reported on concussion information sheet?
Concussion information sheet must report details about concussion incidents, symptoms, diagnosis, treatment, and follow-up care.
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