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OHIO HIGH SCHOOL ATHLETIC ASSOCIATION 4080 Rosella Place Columbus, Ohio 43214 6142672502www.OHSA.orgOHSAA CONCUSSION REPORT State Law, NFHS Rules and OHSA policy require a student who exhibits signs,

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How to fill out concussion report form

01

Obtain a concussion report form from the appropriate organization or medical facility

02

Fill in the patient's personal information such as name, date of birth, and contact information

03

Provide details about the incident that resulted in the concussion, including date, time, and location

04

Describe the symptoms experienced by the patient, such as headache, dizziness, nausea, and confusion

05

Include information about any previous head injuries or concussions the patient may have had

06

Sign and date the form to certify that the information provided is accurate

Who needs concussion report form?

01

Athletes who have suffered a head injury during sports activities

02

Patients who have been involved in accidents resulting in a concussion

03

Individuals who have experienced a fall or blow to the head leading to symptoms of a concussion

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What is concussion report form?

The concussion report form is a document used to report incidences of concussions or head injuries.

Who is required to file concussion report form?

Healthcare providers, schools, and sports organizations are required to file concussion report forms when a concussion or head injury occurs.

How to fill out concussion report form?

To fill out the concussion report form, provide detailed information about the individual who suffered the concussion, the circumstances of the injury, and any treatment received.

What is the purpose of concussion report form?

The purpose of the concussion report form is to track incidences of concussions and head injuries to ensure proper treatment and prevention measures are taken.

What information must be reported on concussion report form?

The concussion report form must include information about the individual who suffered the concussion, the date and location of the injury, symptoms experienced, and any treatment received.

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