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Acute concussion evaluation 2026
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- Click ‘Get Form’ to open the Acute Concussion Evaluation in the editor.
- Begin by filling out the patient’s information, including their name, date of birth, and the date of evaluation.
- In section A, Injury Characteristics, provide details about the injury. Indicate if there was a forcible blow to the head and describe the location of impact.
- For each symptom listed in section B, check '0' for No or '1' for Yes based on whether they have experienced these symptoms since the injury.
- In section C, assess risk factors for protracted recovery by checking all applicable items related to concussion history and other medical conditions.
- Review section D for any red flags that may require immediate medical attention and ensure they are documented.
- Complete sections E and F by selecting appropriate diagnosis codes and outlining a follow-up action plan based on symptoms observed.
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