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CONCUSSION INCIDENT REPORTER FORMFollow the steps on the CATT Concussion Pathway, then document the incident below. This incident form was completed by: NAME:ORGANIZATION:CONTACT INFORMATION:DATE

How to fill out concussion incident report

How to fill out concussion incident report

1. Obtain a concussion incident report form from your school or organization.
2. Begin by providing general information such as the date, time, and location of the incident.
3. Identify the individuals involved in the incident, including the person who suffered the concussion and any witnesses.
4. Provide a detailed description of the incident, including what happened before, during, and after the concussion occurred.
5. Document any symptoms or visible signs of a concussion, such as loss of consciousness, confusion, headache, dizziness, or nausea.
6. Note any immediate care or first aid provided to the person with the concussion.
7. Include information about any medical professionals who evaluated or treated the individual with the concussion.
8. If applicable, document any follow-up plans or recommendations given by medical professionals.
9. Sign and date the concussion incident report, ensuring that all parties involved also provide their signatures if required.
10. Submit the completed report to the appropriate authority within the designated time frame.

Who needs concussion incident report?

1. Concussion incident reports are typically required by educational institutions, sports organizations, and workplaces where concussions may occur.
2. Schools and organizations use these reports to track and monitor concussion incidents, ensure appropriate medical care is provided, and implement any necessary safety measures or protocol changes.
3. Medical professionals may also require concussion incident reports to aid in diagnosing and treating individuals with concussions.
4. Additionally, insurers or legal entities may request these reports as part of claims or legal proceedings related to the incident.

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What is concussion incident report?

A concussion incident report is a formal document used to record details about an incident in which an individual has sustained a concussion. It typically includes information about the circumstances of the incident, the symptoms observed, and the actions taken following the injury.

Who is required to file concussion incident report?

Individuals involved in sports or activities that have inherent risks, as well as coaches, athletic trainers, or administrators, are typically required to file a concussion incident report if a participant is suspected of having a concussion.

How to fill out concussion incident report?

To fill out a concussion incident report, one should provide clear and concise information regarding the incident, including the date and time, location, the individual's details, a description of the incident, symptoms observed, actions taken, and any follow-up care provided.

What is the purpose of concussion incident report?

The purpose of a concussion incident report is to create an official record of the incident for medical review, to help identify patterns in injuries, to ensure proper care is provided to the injured individual, and to comply with legal or regulatory requirements.

What information must be reported on concussion incident report?

Required information on a concussion incident report generally includes the date and time of the incident, the participant's name and details, a narrative of the incident, symptoms exhibited, actions taken at the time of the incident, and any medical evaluation that followed.