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CONCUSSION INFORMATION AND SIGNATURE FORM FOR STUDENTATHLETES & PARENTS/LEGAL GUARDIANS (Adapted from CDC Heads Up Concussion in Youth Sports)Read and keep this page. Sign and return the signature
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Start by obtaining a concussion information and signature form.
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Read the instructions and gather all the required information that needs to be filled out on the form.
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Write clearly and legibly in the specified sections of the form.
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Provide accurate details about the concussion incident, including the date, time, location, and any known symptoms.
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Ensure that all personal information, such as name, date of birth, and contact information, is correctly entered.
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Double-check all the provided information to ensure accuracy and completeness.
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Submit the filled-out and signed form to the relevant organization or healthcare provider.

Who needs concussion information and signature?

01
Anyone who has experienced a concussion, whether it occurred during a sports activity, an accident, or any other head trauma, needs to fill out concussion information and signature forms.
02
These forms are often required by schools, sports teams, healthcare providers, and other organizations to gather information about the incident, assess the severity of the concussion, and ensure appropriate medical care and follow-up.
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Concussion information and signature is a form that must be filled out by individuals involved in sports activities to acknowledge the risks of concussions and agree to follow concussion protocols.
Coaches, athletes, and parents/guardians of minors participating in sports activities are required to file concussion information and signature.
Concussion information and signature forms can be filled out electronically or on paper, and must be completed honestly and accurately.
The purpose of concussion information and signature is to ensure that individuals involved in sports activities are informed about concussions, their risks, and the necessary protocols to follow in case of a suspected concussion.
Concussion information and signature forms typically require individuals to provide personal information, acknowledge concussion risks, and agree to follow concussion protocols.
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