Return to play should occur gradually (see below). Students should be monitored for symptoms and cognitive function during each stage of exertion. Students should only progress to the next level of exertion if they are asymptomatic at the current level. Medical clearance will be provided using the form whose link can be found in the Additional Resources section of these policies and also available on the ________ School website. It is recommended that the student take this form to the medical professional at the time of exam as other forms will not be accepted. These forms must be provided to the coach or athletic trainer and will be shared with the school nurse for review with a copy kept in the student’s medical record. In a situation in which a student has been medically cleared but school staff haveobserved continuing symptoms, the school will make the final decision regarding a student’s to return to play. If this situation arises, the ________ School staff should communicate to the physician or health care provider who provided the clearance regarding the symptoms which school staff have observed, to allowfor reevaluation by the health care provider. It is possible that the health care provider was not aware of the student’s symptoms when the provider gave the clearance. If the athlete still has symptoms, the athlete should NOT return to play.Return to Play Sample Policy 3 (When schools use ImPACt or other testing not required by regulations)[Adapted from Ludlow High School] Following a diagnosed concussion made by a healthcare provider, the student athlete will take a post-injury test within 24 to 48 hours following the head injury. STUDENT ATHLETES WILL NOT BE ALLOWED TO MOVE ONTO 31
FUNCTIONAL/PHYSICAL TESTING UNTIL THEIR IMPACT TEST IS BACK TO THE BASELINE SCORE AND THEY ARE ASYMPTOMATIC. After a student athlete takes their first post-injury test, they will not be re-tested again for 5 days. If after the first post-injury ImPACT test the athlete is not back to his/her baseline,the parent(s) or legal guardian(s) will be notified, and the student athlete will be referred back to their healthcare provider and must have the Concussion Information and Gradual Return to Play form signed by a physician, licensed neuropsychologist, nurse practitioner or certified athletic trainer stating when the athlete is allowed to return play. Following a post-injury test, the certified athletic trainer will take the Concussion Information and Gradual Return to Play form signed by the parent(s) or legal guardian(s) and fill in the date of all post-injury tests taken by each student athlete. The certified athletic trainer will also document the date on which the athlete is asymptomatic and sign the document agreeing that all the above statements are true and accurate.