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UNIVERSITY OF WISCONSIN CROSS ESPORT CLUBS CONCUSSION FORM What is a Concussion? What are the Symptoms of a Concussion? A concussion is a brain injury that: Is caused by a blow to the head From contact

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How to fill out concussion form - parent

01

Step 1: Obtain a copy of the concussion form from your child's school or sports organization.

02

Step 2: Read the instructions and information provided on the form.

03

Step 3: Fill out the personal details section of the form, including your child's name, date of birth, and contact information.

04

Step 4: Provide information regarding any previous concussions or head injuries your child has experienced.

05

Step 5: Answer the questions about your child's current symptoms, such as headache, dizziness, or memory problems.

06

Step 6: Sign and date the form to indicate that you have completed it accurately.

07

Step 7: Return the form to the appropriate person or organization as instructed.

Who needs concussion form - parent?

01

Parents of children participating in school or sports activities where there is a risk of head injury or concussion need to fill out the concussion form.

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What is concussion form - parent?

Concussion form - parent is a form that parents or guardians of student athletes must fill out to report any concussion or head injury their child may have sustained while participating in sports.

Who is required to file concussion form - parent?

Parents or guardians of student athletes are required to file the concussion form on behalf of their child.

How to fill out concussion form - parent?

Parents can fill out the concussion form by providing information about the student athlete, details of the injury, and signatures confirming the accuracy of the information.

What is the purpose of concussion form - parent?

The purpose of the concussion form is to ensure that any head injuries sustained by student athletes are properly reported and managed to prevent further harm.

What information must be reported on concussion form - parent?

The concussion form should include details of the athlete, the injury, symptoms observed, medical treatment received, and any return-to-play instructions.

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