Concussion Form - Palo Alto Unified School District - pausd 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the date at the top of the form. This is essential for record-keeping.
3. Fill in the student’s name and date of birth in the designated fields. Accurate information is crucial for proper identification.
4. Provide details about the referring staff, including their name and contact information, ensuring that communication lines are clear.
5. In the parent/guardian section, sign and date to consent to communication regarding your child’s health status.
6. The health care provider will complete their section after reviewing medical facts. Ensure they fill out all necessary symptoms and recommendations.
7. Review all entries for accuracy before submitting. This ensures that all information is correct and up-to-date.

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