Ohio Youth Concussion Review Completion Form

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Ohio’s Return-to-Play law ( Ohio Revised Code (ORC) 3313.539 or Ohio Revised Code (ORC) 3314.03) requires that Ohio youth athletes who are suspected of sustaining a concussion MUST be removed from practice or play. Ohio laws prohibit a child to return to play (practice or competition) on the same day that he/she is removed on suspicion of having sustained a concussion. He/she may return the following day if cleared in writing by a physician (MD or DO) or other authorized healthcare providers that he/she did not sustain a concussion.

All youth athletes and their parents/guardians must view the Ohio Department of Health (ODH) Youth Concussion information sheets below and then sign this form.

Email address *

By checking YES I am confirming that I have reviewed the Ohio Department of Health's Youth Concussions information sheets in full for the 2025-26 club season. I understand by printing my name below I am submitting my online signature. *

Yes

Athlete/Player Signature *

Parent/Guardian Signature *

Date (MM/DD/YYYY) *

* required field