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Ohio's ReturntoPlay Law Parental/Guardian Confirmation of Receipt of the ODD Concussion Information Sheets Division: Date: Team Number: Coach: Per ORC 3707.52 as enacted by Ohio HE 143 of the 129th
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Start by downloading the concussion info signature form from the official website or obtaining a physical copy from your healthcare provider.
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Read the form carefully and make sure you understand the information provided.
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Fill out your personal details such as your name, age, address, and contact information.
04
Review the concussion information section and make sure you are aware of the signs and symptoms.
05
Sign and date the form to indicate your consent and understanding of the information provided.
06
If required, have a parent or guardian also sign the form if the patient is a minor.
07
Submit the completed form to the appropriate healthcare provider or organization as instructed.

Who needs concussion info signature form?

01
Anyone who has experienced a concussion or is participating in activities where the risk of head injuries is present may need to fill out a concussion info signature form. This can include athletes, children participating in sports, individuals involved in high-risk occupations, or anyone seeking medical advice or treatment related to concussions.
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The concussion info signature form is a document used to collect and verify important information regarding an individual's awareness and acknowledgment of the risks associated with concussions, particularly in sports settings.
Typically, athletes, their parents or guardians, and coaches are required to file the concussion info signature form before the athlete participates in sports activities.
To fill out the concussion info signature form, individuals must provide their personal information, sign the acknowledgment statements about concussions, and may need to receive education on the signs and symptoms of concussions.
The purpose of the concussion info signature form is to ensure that athletes and their guardians understand the serious nature of concussions and the associated risks, promoting safety and awareness in sports.
The form typically requires the athlete's name, date, signatures of the athlete and their guardian, and acknowledgment of receiving information about concussion risks.
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