Get Concussion Return To Play Bformb - Wojfccom

Filling out the Concussion Return To Play Form is essential for ensuring the safety and well-being of athletes recovering from a concussion. This guide provides you with step-by-step instructions to assist you in completing the form accurately and efficiently online.

Follow the steps to complete your form seamlessly.

1. Click the ‘Get Form’ button to access the Concussion Return To Play Form and open it in your preferred document editor.
2. In Section One, entered by the head coach or assistant coach, print the student athlete's name in the designated field. Provide the date, the club's name, the athlete's grade, color, and the number of past concussions.
3. Write a brief description of how the injury occurred and why the concussion is suspected in the specified area.
4. Proceed to Section Two, which must be completed by a licensed health care provider. The provider should print their name, license number, and licensing board in the respective fields.
5. The health care provider must indicate if the student athlete is NOT cleared, cleared with or without restrictions, or provide a detailed schedule for return to play. Ensure that all dates and steps for activities are precisely noted.
6. If the athlete is cleared with a schedule, fill in the dates for each step of the return, from light activity to full game play.
7. The health care provider must sign and date the form at the end to confirm completion.
8. After completing the form, save changes, and download or print a copy for records. Ensure that a copy is submitted to the WOJFC as required.

Complete your documents online to ensure a smooth return to play process.