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Peninsula Little League CONCUSSION INFORMATION SHEET FOR PARENTS AND PLAYERS WHAT IS A CONCUSSION? A concussion is a brain injury. Concussions are caused by a bump or blow to the head. Even a “ding

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How to fill out concussion fact sheet for

01

Start by gathering the necessary information such as the patient's personal details, including name, date of birth, and contact information.

02

Next, provide information about the incident that caused the concussion, including the date, time, and location of the injury.

03

Describe the symptoms experienced by the patient, such as headaches, dizziness, memory loss, or confusion. Be as specific as possible.

04

Include information about any medical treatment received, such as emergency room visits, doctor consultations, or medication prescribed.

05

If applicable, provide details about any previous concussions or head injuries the patient has experienced.

06

Mention any ongoing symptoms or difficulties the patient is facing as a result of the concussion, such as trouble concentrating, mood changes, or difficulties with daily activities.

07

Finally, sign and date the concussion fact sheet to certify its accuracy and completeness.

Who needs concussion fact sheet for?

01

Concussion fact sheets are needed for individuals who have suffered a concussion or head injury.

02

This includes athletes involved in sports activities, victims of accidents or falls, military personnel, and anyone else who has experienced a blow to the head.

03

Healthcare professionals, including doctors, nurses, and therapists, also require concussion fact sheets to assess and monitor the patient's condition.

04

Concussion fact sheets are essential for accurate documentation and communication of concussion-related information between medical professionals and patients.

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What is concussion fact sheet for?

The concussion fact sheet is used to provide information about concussions and their impact on individuals.

Who is required to file concussion fact sheet for?

Healthcare providers, coaches, athletic trainers, and school officials are required to file the concussion fact sheet.

How to fill out concussion fact sheet for?

The concussion fact sheet can be filled out by providing information about the individual's name, date of birth, sport played, date of injury, and symptoms experienced.

What is the purpose of concussion fact sheet for?

The purpose of the concussion fact sheet is to track and monitor concussions in athletes to ensure proper treatment and prevention.

What information must be reported on concussion fact sheet for?

Information such as the individual's name, date of birth, sport played, date of injury, and symptoms experienced must be reported on the concussion fact sheet.

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