Physician (MD DO) Recommended School Accommodations Following Concussion 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the patient's name and date at the top of the form. This information is crucial for identifying the student.
3. In the permission section, have the parent sign and provide their name. This allows communication between the physician and school regarding accommodations.
4. Fill in the dates related to the injury and diagnosis. These dates help track recovery progress.
5. Review each accommodation area carefully. Check boxes for requested modifications based on the student's needs, such as attendance flexibility or specific classroom adjustments.
6. Provide any additional comments or clarifications that may assist school personnel in understanding the student's requirements.
7. Finally, ensure that the physician's name and signature are included along with the exam date before saving or sharing the completed form.

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