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SIX RIVERS YOUTH FOOTBALL CONFERENCE, INC Graded Concussion Symptom Checklist Date: ___ Time: ___Hours of Sleep: ___ ___Date of Diagnosis:Grade the 22 symptoms with a score of 0 through 6. Baseline

How to fill out an examination of concussion

How to fill out an examination of concussion

1. To fill out an examination of concussion, follow these steps:
2. Start by obtaining the examination form from the appropriate medical authority or institution.
3. Read the instructions on the form carefully to understand the requirements and guidelines.
4. Begin by providing your personal details, such as name, date of birth, and contact information.
5. Answer the questions related to the symptoms and history of concussions, if any.
6. Describe the circumstances or incidents that led to the possibility of a concussion.
7. Indicate any previous medical conditions or injuries that may have contributed to the concussion.
8. Provide information about any ongoing medications or treatments being received.
9. Answer additional questions regarding any accompanying symptoms or side effects.
10. Follow any specific instructions or guidelines mentioned on the form.
11. Review your answers for accuracy and completeness before submitting the examination form.
12. Submit the completed form to the designated medical authority or institution within the specified timeframe.
13. Keep a copy of the filled examination form for your records.

Who needs an examination of concussion?

1. An examination of concussion is typically needed by individuals who have experienced a head injury or blow to the head and are showing symptoms associated with concussions.
2. Common examples of people who may need an examination of concussion include:
3. - Athletes involved in contact sports
4. - Individuals involved in accidents or falls
5. - Military personnel exposed to explosive blasts
6. - Victims of physical assault or abuse
7. - Individuals who experience persistent headaches, dizziness, memory problems, or cognitive difficulties after a head injury
8. It is important to consult with a medical professional or follow the guidelines of the relevant medical authority to determine if an examination of concussion is necessary in a specific case.

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What is an examination of concussion?

An examination of concussion is a medical evaluation to assess and diagnose a head injury that results in temporary impairment of brain function.

Who is required to file an examination of concussion?

Athletes who have experienced a head injury that may have resulted in a concussion are required to file an examination of concussion.

How to fill out an examination of concussion?

To fill out an examination of concussion, the athlete must visit a healthcare professional who specializes in head injuries and follow their guidance for completing the evaluation.

What is the purpose of an examination of concussion?

The purpose of an examination of concussion is to ensure the safety and well-being of athletes by providing accurate diagnosis and appropriate treatment for head injuries.

What information must be reported on an examination of concussion?

An examination of concussion must include details of the head injury, symptoms experienced, medical history, physical examination findings, and any recommended treatment plan.