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CONCUSSION RETURNTOPLAY CLEARANCE Patient Name: ___Date: ___Please check and date ONE option below: The athlete named above is cleared to start the graduated, individualized return to competition
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How to fill out return-to-play clearance
How to fill out return-to-play clearance
01
Schedule an appointment with a healthcare provider such as a doctor or athletic trainer.
02
Provide any necessary medical history and documentation related to the injury or condition.
03
Undergo a physical examination to assess the current status of the injury or condition.
04
Follow any recommended treatment plan or rehabilitation program as outlined by the healthcare provider.
05
Once the healthcare provider determines that you are ready, obtain a written clearance for return to play.
Who needs return-to-play clearance?
01
Athletes who have been injured and are looking to return to sports or physical activity.
02
Individuals who have experienced a medical condition that may impact their ability to participate in physical activity.
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What is return-to-play clearance?
Return-to-play clearance is a medical authorization stating that an individual is fit to resume physical activity, specifically after recovering from an injury or medical condition.
Who is required to file return-to-play clearance?
Return-to-play clearance is typically required for athletes, especially those participating in organized sports or events.
How to fill out return-to-play clearance?
Return-to-play clearance forms are usually filled out by a medical professional, such as a doctor or physical therapist, based on the individual's medical history and current physical condition.
What is the purpose of return-to-play clearance?
The purpose of return-to-play clearance is to ensure that individuals do not return to physical activity prematurely, which could potentially exacerbate an existing injury or medical condition.
What information must be reported on return-to-play clearance?
Return-to-play clearance forms typically include information about the individual's medical history, current physical condition, and any relevant treatment or rehabilitation plans.
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