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Concussion Signs and Symptoms Form (5051) Student Name: ___ Grade: ___ Date/Time of Incident:___ Where and how incident occurred: (Be sure to include description of the bump or blow to the head or
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How to fill out concussion signs and symptoms

01
Start by learning the common signs and symptoms of a concussion, such as headaches, confusion, nausea, and sensitivity to light or noise.
02
Keep an eye out for signs of concussion in yourself or others, such as loss of consciousness, memory problems, or changes in mood.
03
If you suspect a concussion, seek medical attention immediately and follow the doctor's recommendations for treatment and recovery.

Who needs concussion signs and symptoms?

01
Concussion signs and symptoms are important for anyone who may have experienced a head injury, such as athletes, accident victims, or anyone who has hit their head in a fall or collision.
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Concussion signs and symptoms include headache, dizziness, confusion, nausea, sensitivity to light and noise, and difficulty concentrating.
Healthcare providers, coaches, and trainers are required to file concussion signs and symptoms.
Concussion signs and symptoms can be filled out by documenting the individual's reported symptoms, conducting a physical examination, and reviewing any history of head injuries.
The purpose of concussion signs and symptoms is to accurately assess and monitor the effects of a head injury on an individual.
Information that must be reported includes the individual's symptoms, physical examination findings, and any relevant medical history.
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