* Required
Return to Participation: I understand that until an athlete who has suffered a concussion is no longer experiencing signs, symptoms, or behaviors consistent with a concussion, and a medical release form signed by an appropriate Health Care Professional (Physician (MD), Physician’s Assistant (PA), Doctor of Osteopathic (DO) licensed by the Oregon State Board of Medicine, nurse practitioner licensed by the Oregon State Board of Nursing, or Psychologist licensed by the Oregon Board of Psychologist Examiners) is obtained, the athlete shall not be permitted to return to athletic activity.
Concussion – Private School Informed Consent Form for STUDENT ATHLETE: I acknowledge the receipt of the information above regarding symptoms and warning signs of concussions in high school sports in compliance with Jenna’s Law, ORS 417.875.