Concussion Head Injury Report Form and Medical Release

Howell Mountain Elementary School District

Uploaded: Feb 22, 2022, 12:13:00 PM

Concussion-Head-Injury-Report-form-and-Medical-Release.pdf

Concussion-Head-Injury-Report-form-and-Medical-Release-SP.pdf

Used by District to track students removed from sports participation who cannot resume participation until they obtain medical clearance. Form also contains required medical clearance form to be executed only by MD/DO (required by law), except for non- concussion situations, where NP/PA can also sign.