Appendix C: Concussion Education Plan Implementation Checklist

1. Identification of a School Concussion Management Team (see appendix A, “School Concussion Management Team”) 
2. Identification of roles and responsibilities of members of the School Concussion Management Team and school personnel (see appendix B, “Suggested Roles and Responsibilities of the School Concussion Management Team and School Personnel”) 
3. Procedures to ensure the provision of concussion education to student athletes prior to participating in any intramural or interscholastic athletic activity (see section 1, “Concussion Education and other Requirements for Students, Parents, and Coaches”) 
4. Procedures to ensure the provision of concussion education to parents or guardians of student athletes prior to the athlete participating in any intramural or interscholastic athletic activity (see section 1, “Concussion Education and other Requirements for Students, Parents, and Coaches”) 
5. Procedures for obtaining parental or legal guardian informed consent attesting to the fact that they have received a copy of such consent form and that they authorize the student athlete to participate in the athletic activity (see section 1, “Concussion Education and other Requirements for Students, Parents, and Coaches”) 
6. Procedures to implement if a student athlete is suspected of sustaining a concussion (see “The Means of Obtaining Proper Medical Treatment for a Person Suspected of Sustaining a Concussion” in section 2) 
7. Communication protocols to ensure the notification by qualified school employees to parents or legal guardians when a concussion has occurred or is suspected in their child as soon as possible and within 24 hours (see section 2, “Concussion Education Plan” and appendix E, “Applicable State and Federal Laws”) 
8. Communication procedures for the timely reporting of all occurrences of concussions and suspected concussions to the school health services staff (such as the school nurse) and other school personnel (such as administrators, athletic trainers, athletic directors, other medical personnel, school counselors, teachers, coaches) to ensure proper care and recovery (see “Current Best Practices in the Prevention and Treatment of a Concussion” in section 2 and appendix B, “Suggested Roles and Responsibilities of the School Concussion Management Team and School Personnel”) 
9. Adoption of return-to-play protocols or procedures (see “The Proper Procedures for Allowing a Student Athlete Who Has Sustained a Concussion to Return to Athletic Activity” in section 2) 
10. Procedures for the collection of all occurrences of concussions for reporting to the State Board of Education, including: (1) the nature and extent of the concussion, and (2) the circumstances in which the student sustained the concussion (see appendix D, “Reporting Requirements by Local and Regional Boards of Education”).