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PostConcussion Symptom Score SheetName: ___ Date of Birth: ___ Date of Injury: ___ School: ___Sport: ___ Last Step Completed #___ Athlete Instructions: Rate your symptoms based on how you feel at
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How to fill out post-concussion symptom score sheet

01
Obtain a copy of the post-concussion symptom score sheet.
02
Read and understand the instructions provided on the sheet.
03
Write your name, date of birth, and other requested personal information at the top of the sheet.
04
Review each symptom listed on the sheet and rate the severity of each symptom on a scale from 0 to 6.
05
Total the scores for each symptom to obtain a cumulative score.
06
Submit the completed score sheet to the healthcare provider responsible for monitoring your concussion symptoms.

Who needs post-concussion symptom score sheet?

01
Individuals who have experienced a concussion or head injury and are being monitored for symptoms.
02
Healthcare providers who are assessing and monitoring patients with concussions or head injuries.
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The post-concussion symptom score sheet is a tool used to assess and quantify the symptoms experienced by an individual following a concussion. It typically lists various symptoms and provides a scale for the individual to rate their severity.
Individuals who have experienced a concussion, particularly athletes or patients under medical care for concussion-related symptoms, are required to complete and file the post-concussion symptom score sheet.
To fill out the post-concussion symptom score sheet, individuals should read through the listed symptoms, rate the severity of each symptom on a scale (often from 0 to 6), and provide any additional comments if required.
The purpose of the post-concussion symptom score sheet is to help healthcare providers evaluate the impact of a concussion on an individual's health and track the progress of recovery over time.
The post-concussion symptom score sheet typically requires reporting of the individual's name, date of evaluation, a list of symptoms, the severity ratings for each symptom, and any relevant medical history.
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