Get the free Concussion Return to Play Clearance Form

Concussion Return to Play Clearance FormStudent/Athlete NameTodays DateDate of BirthDate of InjurySchool NameDate of Initial ExamThe athlete identified above sustained a concussion on the aforementioned

How to fill out concussion return to play

How to fill out concussion return to play

1. Start by providing your personal information including name and date of birth.
2. Include details about the concussion event, such as the date it occurred and how it happened.
3. Record the symptoms experienced after the concussion, such as headaches, dizziness, or confusion.
4. Indicate the date of medical evaluation and whether a healthcare professional diagnosed the concussion.
5. Follow the prescribed rest and recovery period recommended by the healthcare provider.
6. Complete any required symptom assessments or tests as indicated by your healthcare provider.
7. Develop a gradual return-to-play schedule in conjunction with your healthcare professional, detailing steps to increase activity levels safely.
8. Ensure that each step of the return-to-play plan is documented and approved by your healthcare provider.
9. Maintain communication with coaches, trainers, and healthcare providers throughout the process.
10. Be prepared to reassess and adjust the plan based on how the individual is feeling during the return-to-play process.

Who needs concussion return to play?

1. Any athlete who has suffered a concussion and is looking to return to their sport.
2. Coaches and trainers responsible for overseeing the safe return of athletes to play.
3. Parents or guardians of young athletes who need to ensure proper protocols are followed for their child’s wellbeing.

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What is concussion return to play?

Concussion return to play refers to the process and protocol that an athlete must follow after sustaining a concussion before they are allowed to resume participation in sports.

Who is required to file concussion return to play?

Coaches, athletic trainers, and medical professionals are typically required to file the concussion return to play documentation on behalf of the athlete.

How to fill out concussion return to play?

To fill out a concussion return to play form, follow the guidelines provided by your sport organization, complete the athlete's information, document the evaluation results, and include clearance signatures from a qualified healthcare provider.

What is the purpose of concussion return to play?

The purpose of concussion return to play is to ensure the safety of athletes by verifying that they have fully recovered from their concussion and are fit to return to physical activity.

What information must be reported on concussion return to play?

The information that must be reported includes the athlete's name, date of injury, medical evaluation results, symptoms resolution, and medical clearance from a healthcare professional.