San Diego Unified School Athletics protocol for students with possible concussions consists of four forms.  The supervising adult starts the process and uses the school nurse as the main informational point of contact. A student who has begun the concussion protocol should not participate in athletics until they have been given the approval of the school nurse. Once the concussion protocol has begun, the nurse will communicate with counseling and the student’s teachers.  If there are questions about the protocol or the nurse signing off on the students return to learn or play, they should be referred to Nursing and Wellness.

Referral for Concussion SDCS:

  • This form should be completed by the supervising staff member
  • A completed copy should be submitted to the school nurse
  • The original should be sent to the student’s doctor
  • Click here for attachment

Return to Play Form SDCS:

  • Give blank form to student to bring to doctor
  • Upon return to school, this completed form should be given to the school nurse
  • Click here for attachment

Return to Learn Form SDCS:

  • Give blank form to student to bring to doctor
  • Upon return to school, this completed form should be given to the school nurse
  • Click here for attachment

Return to Play Progress Questionnaire:

  • This form should be completed daily by the supervising adult until student is cleared
  • Form should be completed and given to student so they may submit daily to the school nurse
  • Click here for attachment

Concussion Protocol Guide