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Concussion Safety Protocol Template

The following template* is designed as an aid for NCAA schools to consider using in order to satisfy Divisions I, II and III concussion safety protocol legislation. The template highlights all components of the updated NCAA Concussion Safety Protocol Checklist and provides shaded cells that schools may use to personalize their protocol. The NCAA Concussion Safety Advisory Group recommended modifications to the prior Concussion Safety Protocol Checklist, and these recommendations were prescribed by the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports.  The updated Checklist items are highlighted so that the prior Concussion Safety Protocol Template can be modified more easily.  Template content that is outside the scope of the Checklist has been indicated with an asterisk (*) and is included for your convenience and consideration. A signature line for the athletics health care administrator is included in the template. Additional signature lines may be personalized based on the requirements of a school or conference office.

Institutions are not required to use the template; rather, it is offered as a resource to support athletic departments in their concussion safety efforts.  The content of this template is offered for educational purposes only and is not intended to constitute, or be a substitute for, medical or legal advice. The content is not intended to be exhaustive, and we encourage membership to review these materials with applicable campus medical, legal and risk management authorities to determine whether and how best to use this information to address individual institutional risks and requirements. All concussion safety protocols, regardless if developed using the template or another mechanism, must be consistent with all applicable divisional legislative requirements.

*Highlighted content represents an update from the prior template.

Download the Concussion Safety Protocol Template Word document (.docx)

Download the Concussion Safety Protocol Checklist