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Concussion Safety Protocol Template

The following Concussion Safety Protocol 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. Recent updates to the NCAA Concussion Safety Protocol Checklist have resulted in corresponding updates to the prior version of the published Template. Updated content has been highlighted so that it can be more easily identified.  Template content that is outside the scope of the Checklist has been indicated with an asterisk (*) and is included for your convenience and consideration.

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.

This Template includes a sample Written Certification of Compliance form. Division I Constitution requires Division I member institutions to include, as part of the Concussion Safety Protocol, a written certificate of compliance signed by the institution's athletics health care administrator and this form can be used for that purpose. While not legislatively required, the form can also be used by Division II and III institutions that have elected to include a certification as part of their protocol review process.

If you have questions or difficulty accessing the template, please email