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Vista Grande High School Functional Progression Concussion Return to Play: Revised July 2017 Athlete Name: ___Sport/Position: ___ Monitor the athletes symptoms after each phase. Each phase will be
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How to fill out concussion comeback return to

01
Step 1: Obtain the concussion comeback return to form from your healthcare provider.
02
Step 2: Provide information such as your name, date of injury, symptoms, and healthcare provider's recommendations.
03
Step 3: Indicate any accommodations or restrictions that may be needed for your return to activities.
04
Step 4: Review the form with your healthcare provider to ensure accuracy.
05
Step 5: Submit the completed form to the appropriate parties, such as your employer or school.
06
Step 6: Follow any additional instructions provided by your healthcare provider for a safe return to activities.

Who needs concussion comeback return to?

01
Athletes who have sustained a concussion and are looking to return to sports.
02
Individuals who have experienced a concussion in a work or school setting and need approval to resume activities.
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Concussion comeback return is to document the return to play process for athletes who have suffered a concussion.
Coaches, medical staff, and athletes are required to file concussion comeback return.
Concussion comeback return can be filled out by providing information on the athlete's concussion symptoms, treatment plans, and gradual return to play protocol.
The purpose of concussion comeback return is to ensure that athletes safely return to play after suffering a concussion.
Information such as the athlete's symptoms, treatment received, clearance from medical staff, and gradual return to play plan must be reported on concussion comeback return.
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