Get Acute Concussion Evaluation

The Acute Concussion Evaluation is an essential tool used to assess and create a care plan for individuals diagnosed with a concussion. This guide provides clear, step-by-step instructions to help you effectively complete the evaluation online.

Follow the steps to accurately fill out the Acute Concussion Evaluation form.

1. Press the 'Get Form' button to access the Acute Concussion Evaluation form and open it in your online editor.
2. Begin by filling out the patient identification section. Enter the patient's name, date of birth (DOB), age, date of evaluation, ID or medical record number (MR#), and the date of injury.
3. In the symptoms section, carefully review the listed symptoms. Circle or check any symptoms that the patient is currently experiencing to provide an accurate account of their condition.
4. Review the care plan instructions outlined in the form. Make sure to indicate any restrictions on physical activities, academic responsibilities, or social participation as needed.
5. Next, proceed to the 'Returning to School' section. Indicate any recommended supports based on the patient's symptoms, selecting options that align with their current educational needs.
6. In the 'Returning to Sports' section, specify whether the patient should return to sports activities or physical education classes. It is crucial to base decisions on their symptomatology.
7. Complete the gradual return to play plan by marking the appropriate levels of physical activity the patient can safely engage in, considering their recovery progress.
8. Finally, indicate any referrals or follow-up actions based on the evaluation findings, such as scheduling follow-ups or referring to specialists as necessary.
9. After thoroughly reviewing all sections and ensuring all fields are correctly filled, save your changes. You may print, download, or share the completed form as required.

Complete your Acute Concussion Evaluation form online today for efficient and effective care.