Get the free Play and Concussion Clearance Form - Utah Youth Soccer

Concussion Clearance/Follow Up Form (To be presented to parent at time of concussion)Athlete Information Todays Date:___ Date of Injury:___ Date of Birth:___ Athletes Name:___ Club & Team:___ Concussion

How to fill out play and concussion clearance

How to fill out play and concussion clearance

1. Gather necessary documentation including the athlete's medical history and any previous concussion evaluations.
2. Consult with a qualified healthcare provider who specializes in concussion management.
3. Complete the designated concussion screening and assessment forms provided by the healthcare provider.
4. Ensure the athlete is symptom-free and meets the Return to Play (RTP) criteria outlined by the healthcare provider.
5. Fill out the play clearance form, ensuring all required information is filled out correctly.
6. Submit the completed clearance form to the appropriate authority (e.g., coach, school athletic director) prior to resuming play.

Who needs play and concussion clearance?

1. Any athlete who has suffered a concussion or suspected concussion.
2. Individuals participating in contact sports or high-risk activities.
3. Athletes in school or community sports programs typically require clearance after a concussion.

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What is play and concussion clearance?

Play and concussion clearance is a process that ensures an athlete who has experienced a concussion can safely return to play. It involves assessment by a qualified medical professional who evaluates the athlete's symptoms and cognitive function.

Who is required to file play and concussion clearance?

Typically, student-athletes are required to file play and concussion clearance before returning to sports after a concussion. This may also involve parents or guardians and school or sports organizations.

How to fill out play and concussion clearance?

To fill out play and concussion clearance, the designated healthcare provider needs to complete the form, providing information on the athlete's condition, assessment results, and confirmation that the athlete is cleared to return to play.

What is the purpose of play and concussion clearance?

The purpose of play and concussion clearance is to protect athletes from returning to play too soon after a concussion, which can lead to further injury or complications.

What information must be reported on play and concussion clearance?

Play and concussion clearance forms must report details such as the athlete's injury history, symptoms, cognitive assessments, and the healthcare provider's evaluation results and clearance status.