Get the free Concussion Return to Play Protocol

AT18 Florida High School Athletic Association Revised 06/15 Post Head Injury/Concussion Initial Return to Participation (Page 1 of 2) This form is to be completed by an appropriate health care provider

How to fill out concussion return to play

How to fill out concussion return to play:

1. Obtain the appropriate concussion return to play form from your healthcare provider or athletic organization. This form is typically used to track the progress of an individual recovering from a concussion and determine when it is safe for them to return to physical activity.
2. Start by providing personal information at the top of the form. This may include the individual's name, date of birth, and contact information. It is important to fill out this information accurately to ensure proper identification.
3. Next, provide details about the concussion. Include the date of the injury, the circumstances in which it occurred, and any symptoms experienced. It is crucial to document this information as it helps medical professionals understand the severity of the concussion and its potential impact on the individual's ability to return to play.
4. Specify the healthcare provider who has been involved in assessing and managing the concussion. This may include a primary care physician, neurologist, or sports medicine specialist. Provide their name, contact information, and any pertinent details regarding their involvement in the individual's care.
5. Document the treatment plan that has been implemented. This may include rest, medication, physical therapy, cognitive exercises, or any other interventions recommended by the healthcare provider. It is important to accurately report the treatment plan to ensure appropriate evaluation before returning to play.
6. Record any follow-up appointments or evaluations that have taken place. This helps demonstrate the individual's progress and compliance with the recommended treatment plan. Include dates, healthcare providers seen, and any notable findings or changes in symptoms.
7. Finally, provide space for a healthcare provider's signature and date. This indicates that they have reviewed the concussion return to play form and agree that the individual is ready to resume physical activity. The healthcare provider's signature is essential for ensuring that the return to play decision is based on medical expertise and the individual's best interest.

Who needs concussion return to play:

1. Athletes who have experienced a concussion require a concussion return to play assessment. This includes individuals participating in contact sports such as football, soccer, hockey, rugby, and basketball, among others. However, it is important to note that concussions can occur in any sport or recreational activity.
2. Individuals involved in non-athletic activities, such as accidents or falls, may also require a concussion return to play assessment if they have experienced a head injury. It is essential to prioritize the individual's safety and well-being, regardless of the context in which the concussion occurred.
3. It is crucial to consult a healthcare professional to determine if a concussion return to play assessment is necessary. They will consider the individual's symptoms, medical history, and the severity of the concussion to make an informed decision. Following appropriate protocols and guidelines is vital to ensure a safe and successful return to physical activity.

For pdfFiller’s FAQs

What is concussion return to play?

Concussion return to play is a process that outlines the steps and requirements for an athlete to safely return to sports or activities after sustaining a concussion.

Who is required to file concussion return to play?

Athletes who have sustained a concussion are required to file a concussion return to play form.

How to fill out concussion return to play?

Concussion return to play forms can be filled out by the athlete, their parent or guardian, and medical professionals involved in the athlete's care.

What is the purpose of concussion return to play?

The purpose of concussion return to play is to ensure that athletes safely return to sports or activities after a concussion, reducing the risk of further injury.

What information must be reported on concussion return to play?

Concussion return to play forms typically require information about the athlete's concussion history, symptoms, and medical clearance from a healthcare provider.

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