Physical Education Concussion Safety Awareness Form
Student Information
Student Name
Grade
School
Parent/Guardian Information
Parent/Guardian Name
Contact Information
Concussion Safety Awareness
I have reviewed information on the signs, symptoms, and risks of concussions.
I understand the importance of reporting symptoms to a teacher, parent, or coach.
I agree to follow concussion safety protocols at all times.
Signatures
Student Signature
Date
Parent/Guardian Signature
Date
Comments or Questions