Sample Medical Concussion Assessment Form
The Medical Assessment Form is provided to a student that demonstrates or reports concussion signs and or symptoms. For more information consult the Sample Tool to Identify a Suspected Concussion.
The student must be assessed as soon as possible by a medical doctor or nurse practitioner. In Canada, only medical doctors and nurse practitioners are qualified to provide a concussion diagnosis. In rural or northern regions, a nurse with pre-arranged access to a medical doctor or nurse practitioner may be used to assess the suspected concussion. Prior to returning to school, the parents/guardians must inform the school principal of the results of the medical assessment.
Results of the Medical Assessment
For more information, consult the Home Management Plan Form for Return to School (RTS) and Return to Physical Activity (RTPA).