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Attachment Athlete/Parent/Guardian Concussion Information Sheet and Acknowledgement Form A concussion is a type of traumatic brain injury that disrupts normal functioning of the brain. . A concussion
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01
To fill out a concussion information sheet, follow these steps:
02
- Start by writing your name, date of birth, and contact information at the top of the form.
03
- Provide details about the incident that caused the concussion, such as the date, time, and location.
04
- Describe the symptoms you experienced after the incident, including any physical, cognitive, or emotional changes.
05
- Indicate any medical treatment you have received for the concussion, including medications or therapies.
06
- Mention any previous concussions or head injuries you have had in the past.
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- Provide information about your current health status, including any ongoing symptoms or limitations.
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- Lastly, sign and date the form to indicate that the information provided is accurate.

Who needs concussion information sheet and?

01
Anyone who has suffered a concussion or is suspected of having a concussion needs to fill out a concussion information sheet.
02
This could include athletes who have had a head injury during sports activities, individuals involved in accidents or falls that resulted in a head injury, or anyone experiencing symptoms of a concussion.
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A concussion information sheet is a document that outlines key facts about concussions, including symptoms, management, and protocols for returning to play after an injury.
Typically, coaches, athletic directors, and school administrators are required to file the concussion information sheet, especially in educational and sports settings.
To fill out a concussion information sheet, provide accurate contact information, describe any observed symptoms, detail the incident, and sign to acknowledge understanding of concussion protocols.
The purpose of the concussion information sheet is to educate individuals about the risks associated with concussions and to promote awareness of proper procedures for handling suspected head injuries.
The concussion information sheet must report personal information of the athlete, details of the incident, symptoms observed, and any medical evaluation results.
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