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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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Concussion/mild traumatic brain injury is a type of brain injury that is usually caused by a bump, blow, or jolt to the head.
Medical professionals and organizations are required to file concussion/mild traumatic brain injury reports.
To fill out a concussion/mild traumatic brain injury report, one must include details about the individual, the incident, symptoms, and any treatment provided.
The purpose of concussion/mild traumatic brain injury reporting is to track and monitor incidents to better understand the impact of brain injuries.
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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