Get the free uysa concussion clearance form

UTAH YOUTH SOCCER ASSOCIATION CONCUSSION CLEARANCE FORM Utah Youth Soccer Association (USA) has developed this form as a uniform method for Qualified Health Care Providers (Q.H.C.P.) to present a

How to fill out uysa concussion clearance form

How to fill out uysa concussion clearance form:

1. Start by obtaining the form: The uysa concussion clearance form can typically be found on the Utah Youth Soccer Association (UYSA) website or by contacting your local soccer club or UYSA representative.
2. Provide personal information: Begin by filling in your personal details such as name, date of birth, address, and contact information. Make sure to provide accurate and up-to-date information.
3. Medical history: The form usually requires you to disclose any previous history of concussions or head injuries. Answer honestly and provide any relevant details that may be asked, such as the date of the injury and any medical treatment received.
4. Parent or guardian information: If the player is a minor, the form will likely require the parent or guardian to provide their contact information and sign the form on behalf of the player.
5. Medical professional clearance: Depending on the form, there may be a section where a healthcare professional, such as a physician or certified athletic trainer, needs to review and sign-off on the player's suitability to participate in soccer activities after a concussion. Ensure that the medical professional's information is filled out accurately.
6. Return-to-play protocol: In some cases, the form may include a section outlining the steps to be followed for a safe return to play after a concussion. Familiarize yourself with the steps and check off each step as it is completed.
7. Submitting the form: Once the form is complete, follow the instructions provided to submit it to the appropriate parties. This could be your club administrator, team coach, or UYSA representative.

Who needs uysa concussion clearance form:

1. Players: Any youth soccer player participating in UYSA-sanctioned leagues, tournaments, or events may be required to fill out the uysa concussion clearance form. This is to ensure the safety and wellbeing of the players and to comply with UYSA guidelines and concussion protocols.
2. Parents or guardians: If the player is a minor, the uysa concussion clearance form may require a parent or guardian to provide their information and sign the form on behalf of the player.
3. Healthcare professionals: In some cases, a healthcare professional, such as a physician or certified athletic trainer, may need to review and provide clearance on the form before the player can return to soccer activities after a concussion.

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What is uysa concussion clearance form?

The UYSA concussion clearance form is a document used to certify that a player or coach has recovered from a concussion and is medically cleared to return to play.

Who is required to file uysa concussion clearance form?

Players and coaches who have sustained a concussion are required to file the UYSA concussion clearance form.

How to fill out uysa concussion clearance form?

To fill out the UYSA concussion clearance form, relevant medical information regarding the concussion recovery must be reported along with the physician's clearance.

What is the purpose of uysa concussion clearance form?

The purpose of the UYSA concussion clearance form is to ensure the safety of players and coaches by confirming that they are fit to return to play after recovering from a concussion.

What information must be reported on uysa concussion clearance form?

Information such as the date of the concussion, symptoms experienced, treatment received, and physician's clearance must be reported on the UYSA concussion clearance form.