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Upper Ottawa Valley Little League Concussion Return to Play Certification Form Athlete: ___Coach: ___Division: ___Team: ___*****PART A***** The above Athlete was examined by a Medical Professional
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The concussion return-to-play certification form is a document that certifies a student-athlete has completed the necessary evaluations and is cleared by a medical professional to safely return to sports activities after suffering a concussion.
Typically, the form must be filed by the athlete's parent or guardian, along with the healthcare provider who evaluated the athlete, ensuring compliance with sports regulations and safety protocols.
To fill out the form, a healthcare provider must assess the athlete and provide information regarding their evaluation, clearance status, and any recommendations for safe reintegration into physical activities.
The purpose of the form is to ensure the safety of athletes by confirming that they are medically cleared to resume participation in sports after recovering from a concussion.
The form should include the athlete's personal information, details of the concussion event, medical evaluation results, clearance status, and any specific recommendations for returning to play.
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