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Get Concussion Form 15-16

KSHSAA RECOMMENDED CONCUSSION & HEAD INJURY INFORMATION RELEASE FORM 20152016 This form must be signed by all student athletes and parent/guardians before the student participates in any athletic.

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How to fill out the Concussion Form 15-16 online

Understanding how to complete the Concussion Form 15-16 online is essential for ensuring the safety of student athletes. This guide will provide detailed instructions on filling out the form accurately and effectively.

Follow the steps to complete the Concussion Form 15-16 online.

  1. Press the ‘Get Form’ button to access the Concussion Form 15-16 and open it in your preferred editing application.
  2. Begin by filling out the student-athlete's name in the designated field, ensuring it is printed clearly.
  3. Sign the form where indicated for the student-athlete, confirming their acknowledgment of the concussion information.
  4. Fill in the date of signing for the student-athlete, using the format MM/DD/YYYY.
  5. Next, the parent or legal guardian should print their name in the provided space, ensuring accuracy.
  6. The parent or guardian must sign the form, demonstrating their consent and understanding of the concussion guidelines.
  7. Lastly, complete the date field for the parent or guardian's signature, again using the format MM/DD/YYYY. After completing the form, save any changes made, and choose to download, print, or share the document as needed.

Complete your Concussion Form 15-16 online today to ensure the safety of student athletes.

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Grade 1 adds a dazed feeling lasting less than a minute. In Grade 2 concussion the cloudy senses last longer, and the patient may have dizziness, amnesia, confusion, ringing in the ears, and/or irritability. Loss of consciousness characterizes Grade 3 (for less than a minute), and Grade 4 (for longer than a minute.)

Grade 1, Mild: Symptoms that last less than 15 minutes and entail no loss of consciousness. Grade 2, Moderate: Symptoms that last for longer than 15 minutes and involve no loss of consciousness. Grade 3, Severe: The person loses consciousness.

grade 4: loss of consciousness for longer than a minute.

An initial score of less than 5 is associated with an 80 percent chance of a lasting vegetative state or death. An initial score of greater than 11 is associated with a 90 percent chance of complete recovery (Teasdale and Jennett, 1974).

Patients with grade 3 concussion can experience speech difficulty, amnesia for more than 24 hours, vomiting, and seeing stars. The symptoms of a grade 3 concussion are also the longest-lasting before they improve and subside.

The signs and symptoms of concussion reported within 1 to 7 days post injury (see Table 3-3) typically fall into four categories—physical (somatic), cognitive, emotional (affective), and sleep—and patients will experience one or more symptoms from one or more categories.

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