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SMM USD Health Services Department TH 1651 16 Street, Santa Monica CA 90404 (310) 4508338CONCUSSIONRETURNTOLEARN/PHYSICIANRECOMMENDEDSCHOOLACCOMMODATIONS StudentName: DateofBirth: DateofEvaluation:
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To fill out the concussion-return-to-learndocx, follow these steps:
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Open the concussion-return-to-learndocx file in a compatible word processing software.
03
Read and understand the instructions provided at the beginning of the document.
04
Fill in your personal information, such as name, date of birth, and contact details.
05
Provide information about the concussion incident, including the date, location, and how it occurred.
06
Document any symptoms you experienced after the concussion, such as headaches, dizziness, or memory problems.
07
Indicate any previous concussions or head injuries you have had in the past.
08
Include any medical treatment or interventions you have received for the concussion.
09
Follow the guidelines provided by your healthcare professional or school in documenting your return-to-learn plan.
10
Review the completed document for accuracy and completeness before saving or printing it.
11
Consult with your healthcare professional or school staff if you have any questions or concerns during the process.
Who needs concussion-return-to-learndocx?
01
Concussion-return-to-learndocx is needed by individuals who have experienced a concussion and need to document their return-to-learn plan. This may include students, athletes, or anyone who has suffered a head injury and requires accommodations or support in their academic or learning environment to aid in their recovery. It is typically used in educational settings like schools or universities, as well as healthcare facilities where concussion management is a priority.
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What is concussion-return-to-learndocx?
Concussion-return-to-learndocx is a document that outlines the procedures and guidelines for students returning to learning activities after a concussion.
Who is required to file concussion-return-to-learndocx?
Students who have experienced a concussion and are returning to school are required to file concussion-return-to-learndocx.
How to fill out concussion-return-to-learndocx?
Concussion-return-to-learndocx can be filled out by providing relevant information about the student's concussion, treatment plan, and accommodations needed for returning to learning.
What is the purpose of concussion-return-to-learndocx?
The purpose of concussion-return-to-learndocx is to ensure the safe and successful return of students to learning activities after a concussion.
What information must be reported on concussion-return-to-learndocx?
Information such as the student's concussion history, symptoms, treatment plan, and accommodations needed for returning to learning must be reported on concussion-return-to-learndocx.
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