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Page 9 Individual ImPACT Consent Form

Page 9 Individual ImPACT Consent Form 2026

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The document is an ImPACT Consent Form for the Immediate Post-Concussion Assessment and Cognitive Testing program, requiring signatures from both a parent and a student-athlete to participate. It confirms that the parties have read and understood the information provided, agree to follow testing instructions, and acknowledge the importance of valid testing.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the printed name of the athlete in the designated field. Ensure accuracy as this identifies the participant.
Next, specify the sport(s) that the athlete is involved in. This information is crucial for context regarding their participation.
Read through the consent statement carefully. This section confirms that you understand the information provided and have had your questions answered.
In the 'Print Parent’s Name' field, enter your name clearly. This identifies who is giving consent for the athlete's participation.
Sign in the 'Signature of Parent' area to validate your agreement. Make sure to date your signature accurately.
For student-athletes, repeat steps 4 to 6 by printing their name and signing where indicated, ensuring they also date their signature.

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What is an example of a consent form?

Consent form 1 is for adults and those patients having anaesthetic Consent form 2 is for paediatrics Consent form 3 is for procedures without sedation Consent form 4 should be used when the patients lack capacity and should be completed by the professional doing the procedure.

What are the three requirements of a consent form?

In some cases, you may be able to write your own parental consent forms like if your child needs permission to miss class for a dentist appointment. In this case, you can compose a short letter of permission sharing the applicable dates and information, as well as your name and signature.

Do consent forms hold up in court?

That is, the patient must have capacity to consent, the consent must be freely given and be sufficiently specific to the treatment, and the patient must be informed about the procedure and any material risks.

Can I make my own consent form?

A statement that the study involves research, an explanation of the purposes of the research and the expected duration of the subjects participation, a description of the procedures to be followed, and identification of any procedures which are experimental.

Does a consent form need to be docHubd?

U.S. Customs and Border Protection (CBP) recommends carrying a docHubd letter of consent, especially when a child is traveling internationally with one parent, another adult, or alone, to prevent misunderstandings related to custody or abduction.

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What are 5 pieces of information that must be on a consent form?

I have read and I understand the provided information and have had the opportunity to ask questions. I understand that my participation is voluntary and that I am free to withdraw at any time, without giving a reason and without cost. I understand that I will be given a copy of this consent form.

Page 9 Individual ImPACT Consent Form 2026

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