High School Football Concussion Consent Form

Student Athlete Information

Concussion Information

Please review the following important facts about concussions:

• A concussion is a brain injury caused by a bump, blow, or jolt to the head or body.
• Symptoms can include confusion, headache, dizziness, nausea, and more.
• It is important to report any suspected concussion to coaches, parents, or medical professionals immediately.
• Athletes should not return to play until cleared by a qualified healthcare provider.

Consent & Agreement

I have read and understand the facts about concussions. I agree to report any signs or symptoms of a concussion to appropriate personnel. I acknowledge that there are risks associated with participation in high school football, including the risk of concussion.