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CLIENT INFORMATIONConcussion Baseline Testing
Last Name:___Filename:___MiddleInitial:___
Address:___Apt:___
City:___State:___Zip:___
Date of Birth:___Sex:___
Home Phone #:___Work #:___ Cell #:___
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How to fill out consent for concussion baseline
How to fill out consent for concussion baseline
01
Make sure you have the appropriate consent form for concussion baseline testing.
02
Fill out the participant's name, date of birth, and contact information.
03
Provide information on the purpose of the concussion baseline testing.
04
Have the participant or their guardian sign and date the form.
05
Keep a copy of the completed consent form for your records.
Who needs consent for concussion baseline?
01
Any individual participating in a sports program or activity that carries a risk of concussion should have consent for concussion baseline testing.
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What is consent for concussion baseline?
Consent for concussion baseline is a form signed by an individual or guardian giving permission for a baseline concussion test to be conducted.
Who is required to file consent for concussion baseline?
Any individual participating in a contact sport or activity that poses a risk for concussion is required to file consent for concussion baseline.
How to fill out consent for concussion baseline?
Consent for concussion baseline can be filled out by providing personal information, signing the form, and submitting it to the appropriate organization or healthcare provider.
What is the purpose of consent for concussion baseline?
The purpose of consent for concussion baseline is to ensure that individuals have the opportunity to undergo a baseline concussion test before participating in activities that may result in head injuries.
What information must be reported on consent for concussion baseline?
Information such as name, date of birth, contact information, medical history related to concussions, and signature of consent must be reported on consent for concussion baseline.
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