CONCUSSION INFORMATION FOR PARENTS/GUARDIANS:
I have read and understand the Concussion Information sheet for Parents/Guardians below. I understand that any athlete who exhibits signs, symptoms or behaviors consistent with a concussion following an observed or suspected blow to the head or body, or who has been diagnosed with a concussion, shall not be permitted to any other athletic contest or practice on that same day. In schools which have the services of an athletic trainer registered by the Oregon Health Licensing Office, that athletic trainer may determine that an athlete has not exhibited signs, symptoms or behaviors consistent with a concussion, and has not suffered a concussion, and will determine if the athlete can return to play. Athletic trainers may also work in consultation with an appropriate Health Care Professional in determining when an athlete is able to return to play following a concussion.
*CONCUSSION-RETURN TO PARTICIPATION MEDICAL RELEASE: I have read and understand the Concussion-Return to Participation Medical Release form and information below. I understand that until an athlete, who has suffered a concussion, is no longer experiencing signs, symptoms, or behaviors consistent with a concussion, and a medical release form signed by an appropriate Health Care Professional (Physician (MD), Physician’s Assistant (PA), Doctor of Osteopathic (DO) licensed by the Oregon State Board of Medicine, nurse practitioner licensed by the Oregon State Board of Nursing, or Psychologist licensed by the Oregon Board of Psychologist Examiners) is obtained, the athlete shall not be permitted to return to athletic activity.
*OSAA CONCUSSION-PRIVATE SCHOOL INFORMED CONSENT FORM: I have read and understand the OSAA Concussion-Private School Informed Consent form below regarding information about the symptoms and warning signs of concussions in high school sports in compliance with Jenna’s Law, ORS 417.875.
*CONCUSSION RETURN TO ACTIVITY PROTOCOL: I understand that an in-season athlete is required to complete a progressive return-to-activity program supervised by the Central Catholic Athletic Trainer, in addition to a signed medical release. Out-of-season athletes who are diagnosed with a concussion are also required to complete this return-to-activity program with Central Catholic’s Athletic Trainer or an appropriate Health Care professional. (See above list of Health Care professionals.)
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