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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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