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Edmonds Home School Resource Center Concussion Information Sheet A concussion is a brain injury and all brain injuries are serious. They are caused by a bump, blow, or jolt to the head, or by a blow
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How to fill out concussion information sheet

01
Fill out the patient's personal information, including their name, address, and contact information.
02
Provide details about the incident that caused the concussion, such as the date, time, and location.
03
Describe the symptoms that the patient is experiencing, including any physical, cognitive, or emotional changes.
04
Note any previous concussion history or related medical conditions the patient may have.
05
Include information about the healthcare provider who is treating the patient for the concussion, including their name, contact information, and any prescribed treatments or medications.
06
Sign and date the concussion information sheet to acknowledge that the information provided is accurate and complete.

Who needs concussion information sheet?

01
Anyone who has suffered a concussion and is seeking medical treatment or evaluation should fill out a concussion information sheet. This includes athletes, individuals involved in accidents or trauma, and anyone exhibiting symptoms of a concussion. Concussion information sheets help healthcare providers to gather necessary information about the patient's condition, history, and symptoms in order to provide appropriate treatment and care.
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A concussion information sheet is a document that provides important information about concussions, including symptoms, recovery protocols, and guidelines for managing the condition.
Individuals involved in organized sports, including coaches, athletes, and educational institutions, are typically required to file a concussion information sheet.
To fill out a concussion information sheet, individuals must provide personal information, details about the incident, symptoms experienced, and any medical evaluations or treatments received.
The purpose of the concussion information sheet is to educate individuals on the risks associated with concussions, ensure proper procedures are followed for diagnosis and treatment, and promote safe return-to-play protocols.
The information that must be reported includes personal details of the individual affected, a description of the incident, observed symptoms, and actions taken post-injury.
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