Swimmer Concussion Form

All swimmers must fill out this form before being allowed to swim for FHS.
If your family has more than one swimmer, please have each swimmer fill this form out.
click here to open an additional concussion form

Swimmer Name *

I have read the concussion symptoms on the Concussion Information Sheet. *

http://www.tssaa.org/wp-content/uploads/concussionparents.pdf

A concussion is a brain injury which should be reported to my parents, my coach(es) or a medical professional if one is available. *

I will/my child will need written permission from a health care provider* to return to play or practice after a concussion. *

Most concussions take days or weeks to get better. A more serious concussion can last for months or longer. *

After a bump, blow or jolt to the head or body an athlete should receive immediate medical attention if there are any danger signs such as loss of consciousness, repeated vomiting, or a headache that gets worse. *

After a concussion, the brain needs time to heal. I undestand that I am/my child is much more likely to have another concussion or more serious brain injuty if return to play or practice occurs before the concussion symptoms go away. *

Somtimes repeat concussion can cause serious and long-lasting problems and even death. *

SWIMMER NAME THAT MATCHES ABOVE NAME ---I acknowledge that typing my name is my signature agreeing that I have read and agree with the concussion protocol.

(SWIMMER NAME and date)

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Swimmer Concussion Form

FHS Rebels Team

Swim Registration Steps

Swimmer Concussion Form

FHS Rebels Team

Swim Registration Steps

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