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North Shore Country Day School 310 Green Bay Road Winnetka, Illinois 60093 4094 T 847.441.3333 F 847.881.8516 www.nscds.org Concussion Information form 2013-2014 For all Middle and Upper School Students

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How to fill out concussion information form 2013-2014

How to fill out a concussion information form 2013-2014:

01

Gather information: Begin by gathering all relevant personal information such as your full name, date of birth, address, and contact information. This information will help identify the individual completing the form.

02

Details about the concussion: Provide accurate information regarding the concussion, including the date it occurred, the location, and any symptoms experienced. It may also be necessary to provide details about the cause or event that led to the concussion.

03

Medical history: Include any relevant medical history, such as previous concussions or head injuries, pre-existing conditions, or medications being taken. This information helps healthcare professionals assess the severity and potential risks associated with the concussion.

04

Contact information: Provide emergency contact information, including the name, phone number, and relationship of at least one person to be contacted in case of an emergency related to the concussion.

05

Consent and acknowledgment: Read through the entire form carefully to ensure understanding. Sign and date the form, acknowledging that you have provided accurate information to the best of your knowledge.

Who needs a concussion information form 2013-2014:

01

Athletes: Concussion information forms are often required for athletes participating in sports or similar activities where head injuries are common. It helps organizations and medical professionals assess the risks and provide appropriate care when concussions occur.

02

Parents or guardians: If the individual filling out the form is a minor, their parent or legal guardian may need to complete the concussion information form on their behalf. This ensures that accurate and necessary information is provided for a proper evaluation and treatment plan.

03

Educational institutions: Schools and colleges that have sports programs typically require athletes to complete concussion information forms. This helps the institution coordinate with healthcare providers and implement appropriate protocols for managing concussions and ensuring student-athlete safety.

04

Employers or organizations: Some workplaces or organizations that engage in high-risk activities or physical labor may also require employees or members to complete concussion information forms. This allows them to assess risks, implement safety measures, and provide appropriate medical care in case of a concussion.

In conclusion, it is important to accurately fill out a concussion information form 2013-2014 by providing personal details, information about the concussion, medical history, emergency contacts, and signing to acknowledge the accuracy of the provided information. Athletes, parents/guardians, educational institutions, and employers/organizations are among those who typically need to complete such forms.

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What is concussion information form?

The concussion information form is a document used to report information related to concussions in sports.

Who is required to file concussion information form?

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

How to fill out concussion information form?

The concussion information form can be filled out by providing details about the athlete, the concussion incident, and any related medical treatment.

What is the purpose of concussion information form?

The purpose of the concussion information form is to track and report instances of concussions in sports to ensure proper management and prevention.

What information must be reported on concussion information form?

The concussion information form must include details such as the athlete's name, age, sport, date of concussion, symptoms, and medical treatment.

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