Get Ace Concussion

Filling out the Ace Concussion form online is a crucial step in the evaluation of individuals with suspected concussions. This guide will provide clear and supportive instructions on how to navigate each section of the form so that users can complete it accurately and efficiently.

Follow the steps to complete the Ace Concussion form smoothly.

1. Press the ‘Get Form’ button to obtain the Ace Concussion form and open it in a user-friendly interface.
2. Begin by entering the patient's name, date of birth, and the date of the evaluation in the designated fields at the top of the form.
3. In the injury characteristics section, fill in the date and time of the injury, and specify the user's age and ID/mr#. Indicate who is reporting the injury by selecting the appropriate option: patient, parent, spouse, or other.
4. For injury description, indicate if there was a forcible blow to the head and whether there is evidence of intracranial injury or skull fracture by checking 'Yes,' 'No,' or 'Unknown.'
5. Specify the location of impact by selecting one or more areas from the provided list, and indicate the cause of the injury by choosing from the options available.
6. Assess and document any amnesia, loss of consciousness, and early signs of concussion as required, providing duration details where applicable.
7. Complete the symptom checklist by recording the presence of symptoms experienced since the injury, categorizing them into physical, cognitive, emotional, and sleep-related symptoms.
8. Total the scores for each symptom category and calculate the overall symptom score based on the scoring instructions provided.
9. In the risk factors section, check all relevant items that may apply to the user's health history, including concussion history, headache history, and psychiatric history.
10. Review and indicate any red flags present that require immediate attention, ensuring to provide detail as requested.
11. Choose the appropriate diagnosis from the options provided in the diagnosis section based on the evaluations completed.
12. Outline the follow-up action plan, indicating if further monitoring or referrals are necessary. Ensure to document who completed the form.
13. Once all sections are completed, review for accuracy, then save the changes and use options available to download, print or share the Ace Concussion form.

Complete the Ace Concussion form online today to ensure a comprehensive evaluation.