Concussion Form
I acknowledge that I have read and understand the student and parent information sheet on concussions provided by NYSPHSAA. I understand my child:
*
1. Will not return to play on the same day of play.
2. Will need appropriate medical clearance before returning to play if a concussion is suspected
3. After appropriate medical clearace, will return to play following the RETURN TO PLAY PROTOCOL.
Student Athlete's Name
*
First Name
Last Name
Parent/Guardian Signature
*
First Name
Last Name
Date
*
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Month
-
Day
Year
Date Picker Icon
Submit
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