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Concussion Management Protocol Summary and Acknowledgement Athlete Name: ___Injury Date: ___Sport: ___Campus: ___1) Athlete evaluated to have sustained a concussion Red Flag symptoms Refer immediately
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01
Obtain a heads up concussion form from a healthcare provider or sports organization.
02
Fill out the individual's personal information including name, age, and contact information.
03
Provide details about the circumstances of the head injury including when it occurred and how it happened.
04
Note any symptoms the individual is experiencing such as headache, dizziness, or nausea.
05
Include information about any previous concussions or head injuries the individual has experienced.
06
Sign and date the form to verify the information provided.

Who needs heads up concussion in?

01
Anyone who has experienced a head injury, particularly athletes involved in contact sports like football, soccer, or hockey, should fill out a heads up concussion form.
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Heads up concussion form is designed to report concussions.
Coaches, parents, and medical professionals are required to file heads up concussion form.
Head up concussion form can be filled out online or on paper.
The purpose of heads up concussion form is to ensure that concussions are properly reported and managed.
Information such as date of injury, symptoms, and treatment must be reported on heads up concussion form.
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