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Ontario Physical Activity Safety Standards in Education School Concussion Management Form (Return to School Plan)January 2020___School Concussion Management Form (Return to School Plan) The Return
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How to fill out home concussion management form

01
Obtain the home concussion management form from a healthcare provider.
02
Fill out personal information such as name, date of birth, and contact information.
03
Provide details about the concussion incident, including when and how it occurred.
04
List any symptoms experienced since the concussion, such as headache, dizziness, or memory problems.
05
Note any treatments or medications being used for the concussion.
06
Follow any specific instructions or guidelines provided on the form by the healthcare provider.
07
Keep the form in a safe and easily accessible place for reference during recovery.

Who needs home concussion management form?

01
Individuals who have experienced a concussion and are managing their recovery at home.
02
Parents or caregivers of individuals who have experienced a concussion and are helping them with their recovery.
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Home concussion management form is a document used to track and manage concussions that occur at home.
Parents or guardians of minors who have experienced a concussion at home are required to file the form.
The form can be filled out by providing detailed information about the concussion incident, symptoms, treatment, and recovery progress.
The purpose of the form is to ensure proper tracking and management of concussions that occur at home, as well as to facilitate communication between healthcare providers and caregivers.
Information such as date of injury, symptoms, treatment received, recovery progress, and any follow-up care must be reported on the form.
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