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Douglas County School District Head Injury Medical Professional Referral Name: School: DOI:DOB: Grade: Mechanism:Legend High SchoolPrevious Head Injuries:Initial Presentation: Physical Symptoms Headache/Pressure

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How to fill out concussion information acknowledgment form

01

Obtain the concussion information acknowledgment form from your school, sports team, or organization.

02

Read the form carefully, paying attention to the information provided about concussions and the risks involved.

03

Fill out your personal details such as name, date of birth, and contact information.

04

Sign and date the form to acknowledge that you have received and understood the information provided about concussions.

05

Return the completed form to the relevant authority within the specified deadline.

Who needs concussion information acknowledgment form?

01

Athletes participating in sports competitions

02

Students attending schools or universities with concussion policies

03

Employees working in organizations where concussions may occur

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What is concussion information acknowledgment form?

The concussion information acknowledgment form is a document that confirms an individual's understanding of the risks and symptoms associated with concussions.

Who is required to file concussion information acknowledgment form?

Athletes, parents of minor athletes, and coaches are typically required to file concussion information acknowledgment forms.

How to fill out concussion information acknowledgment form?

Concussion information acknowledgment forms can usually be filled out by providing contact information and signing to indicate that the information has been received and understood.

What is the purpose of concussion information acknowledgment form?

The purpose of the concussion information acknowledgment form is to ensure that individuals involved in sports activities are aware of the risks and symptoms of concussions.

What information must be reported on concussion information acknowledgment form?

The concussion information acknowledgment form typically includes information about concussion risks, symptoms, prevention, and reporting procedures.

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