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Concussion Learning Assessment & School Survey (CLASS) Parent report Initial Appointment Name of Child: ___ DOB: ___ Age: ___ Today's Date: ___ Name of School: ___ State/ County: ___ Grade: ___ My

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How to fill out concussion assessment in form

01

Start by providing general information such as name, age, and date of birth.

02

Include details about the injury, such as how it occurred and any symptoms experienced.

03

List any previous concussions and their dates.

04

Fill out the section on physical and cognitive symptoms.

05

Complete any other sections specific to the form you are using.

06

Review the completed form for accuracy before submitting.

Who needs concussion assessment in form?

01

Individuals who have suffered a head injury or suspect they have a concussion.

02

Athletes participating in contact sports.

03

Individuals involved in high-risk activities such as biking or skiing.

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What is concussion assessment in form?

Concussion assessment form is a tool used to evaluate and document the symptoms and severity of a concussion.

Who is required to file concussion assessment in form?

Any individual who has suffered a concussion or is suspected of having a concussion is required to file a concussion assessment form.

How to fill out concussion assessment in form?

To fill out a concussion assessment form, one must provide information about the symptoms experienced, the cause of the injury, and any medical history relevant to the concussion.

What is the purpose of concussion assessment in form?

The purpose of a concussion assessment form is to track and monitor the progress of a concussion, as well as to ensure that proper treatment is provided.

What information must be reported on concussion assessment in form?

Information such as the date of injury, symptoms experienced, medical history, and any treatment received must be reported on a concussion assessment form.

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