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MANDATORY HEAD INJURY SYMPTOM CHECKLIST (Report any of the following symptoms over the last 24 hours)Reported Symptoms Over the Last 24 hoursYesNoExplanation (Required for Yes Answers)Headache Nausea
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How to fill out concussionmild traumatic brain injury
01
Seek medical attention immediately if you suspect a concussion or mild traumatic brain injury.
02
Rest and avoid activities that may worsen symptoms, such as physical or mental exertion.
03
Follow the treatment plan prescribed by a healthcare professional, which may include rest, medication, and physical therapy.
04
Gradually return to normal activities only after clearance from a medical professional.
05
Avoid activities that pose a risk of another head injury while recovering.
Who needs concussionmild traumatic brain injury?
01
Anyone who has experienced a blow to the head, whether from a sports injury, car accident, fall, or other traumatic event, should be evaluated for a concussion or mild traumatic brain injury.
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What is concussion/mild traumatic brain injury?
Concussion/mild traumatic brain injury is a type of brain injury that is usually caused by a bump, blow, or jolt to the head.
Who is required to file concussion/mild traumatic brain injury?
Medical professionals and organizations are required to file concussion/mild traumatic brain injury reports.
How to fill out concussion/mild traumatic brain injury?
To fill out a concussion/mild traumatic brain injury report, one must include details about the individual, the incident, symptoms, and any treatment provided.
What is the purpose of concussion/mild traumatic brain injury?
The purpose of concussion/mild traumatic brain injury reporting is to track and monitor incidents to better understand the impact of brain injuries.
What information must be reported on concussion/mild traumatic brain injury?
Information such as the individual's demographics, details of the incident, symptoms experienced, and any treatment provided must be reported on a concussion/mild traumatic brain injury report.
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