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ArizonaRegionofUSAVolleyball MildTraumaticBrainInjury(MTBI)/Concussion 20232024StatementandAcknowledgementForm I,___(athlete),acknowledgethatIhavetobean activeparticipantinmyownhealthandhavethedirectresponsibilityfor reportingallofmyinjuriesandillnessestotheorganizationsstaff(e.g., coachesorathletictrainingstaff)

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How to fill out mild traumatic brain injury

01

Seek medical attention immediately if you suspect a mild traumatic brain injury.

02

Follow the healthcare provider's instructions for rest and recovery.

03

Avoid activities that could worsen the injury, such as contact sports or heavy lifting.

04

Get plenty of rest and sleep to help the brain heal.

05

Monitor symptoms closely and report any changes to the healthcare provider.

Who needs mild traumatic brain injury?

01

Anyone who has experienced a head injury, such as from a fall, car accident, or sports-related incident, should be evaluated for a mild traumatic brain injury.

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What is mild traumatic brain injury?

Mild traumatic brain injury (MTBI) is a type of brain injury that occurs after a bump or jolt to the head or body, resulting in a brief change in mental status or consciousness. Symptoms may include headaches, confusion, dizziness, and temporary loss of consciousness.

Who is required to file mild traumatic brain injury?

Individuals who have sustained a mild traumatic brain injury, healthcare providers, and sometimes employers are required to file reports regarding the incident, particularly in cases related to workers' compensation or personal injury claims.

How to fill out mild traumatic brain injury?

To fill out the mild traumatic brain injury report, individuals should provide detailed information about the circumstances of the injury, symptoms experienced, medical treatment received, and any relevant witness statements or documentation.

What is the purpose of mild traumatic brain injury?

The purpose of documenting a mild traumatic brain injury is to assess the impact of the injury on daily functioning, to facilitate appropriate medical treatment, and to support potential claims for compensation or benefits.

What information must be reported on mild traumatic brain injury?

The report must include details such as the date and time of the injury, location, nature of the incident, description of symptoms, medical care received, and any follow-up assessments.

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