Concussions

Patient Forms

For all of our concussion patients…
 
In order to ensure the best quality of care we can provide for you child, we ask that all concussion patients arrive 15 minutes prior to their appointment. Each visit you or your child will need to fill out some paperwork before we can begin the appointment.
 
Before your first appointment please print and fill out the Concussion New Patient Form, Graded Symptom Scale and Patient Health Questionnaire. For all follow up appointments please fill out ONLY the Graded Symptom Scale and Patient Health Questionairre.

 

  1. Concussion New Patient Form
  2. Graded Symptom Scale and Patient Health Questionnaire for Children 12 and Under
  3. Graded Symptom Scale and Patient Health Questionnaire for Children 13 and Over

  

Select from over 100 symptoms to learn about managing your child's illness.