Concussion protocol template for schools and sports teams
A free, editable concussion protocol template, written by a board-certified sports neurologist, that a school, district, club, or team can adopt and customize to its own program and state law.
Last reviewed: June 30, 2026 by Dr. Neil J. Patel, MD, MBA (board-certified in Neurology and Brain Injury Medicine; fellowship-trained in Sports Neurology).
Download the free template
An editable, plain-language concussion protocol you can drop your program's name into and adapt. Includes recognition, removal, evaluation, return-to-play, and return-to-learn sections plus a documentation log.
Free to use and adapt for your program. Not medical or legal advice; confirm your state's requirements before adopting.
What a compliant concussion protocol must include
A defensible school or team concussion protocol covers the full arc from suspected injury to full return. At minimum it should address:
- Education & acknowledgment: annual concussion education for coaches, athletes, and parents, with a signed acknowledgment on file.
- Recognition & immediate removal: "when in doubt, sit them out." Any athlete with a suspected concussion is removed from play immediately and not returned the same day.
- Evaluation: assessment by an appropriate healthcare provider, using a standardized tool (e.g., SCAT6) where applicable.
- Return-to-learn: graduated return to academics with accommodations before full return to sport.
- Return-to-play: the 6-step graduated protocol, each step symptom-free for a minimum period before advancing, with written medical clearance.
- Documentation: an injury and clearance log, plus the signed return-to-play form for each athlete.
- Roles & annual review: who is responsible for each step, and a yearly review as guidance and state law change.
How to customize it for your state
Every state's youth-sports concussion law differs on two points that your protocol must match: who is allowed to clear an athlete and any mandatory waiting period before return. Check your state's exact rules and required clearance provider before you adopt this template.
See the state-by-state breakdown: Youth concussion return-to-play rules by state.
Protocol template vs. return-to-play form
These are two different documents and you need both. The protocol (policy) is the program-wide rulebook this page provides. The return-to-play form is the single clearance document a provider signs for one athlete at the end of recovery.
Get the companion form here: Free printable concussion return-to-play form (PDF).
Want a neurologist to review your policy?
Dr. Patel builds and reviews program-level concussion policies for schools and athletic organizations, aligned to your state's law and current consensus.
Frequently asked questions
Is there a free concussion protocol template for schools and sports teams?
Yes. This page offers a free, editable concussion protocol template (DOCX and PDF) written by a board-certified sports neurologist. It is a starting framework you customize to your program and your state's law.
What is the difference between a concussion protocol template and a return-to-play form?
A concussion protocol (or policy) is the program-wide document that defines how your school or team recognizes, removes, evaluates, and clears athletes. A return-to-play form is the single clearance document a provider signs for one athlete. You need both.
Does this template meet my state's concussion law?
The template is built around current consensus and includes the elements most state youth-sports concussion laws require, but every state differs. Cross-check the required clearance provider and waiting periods for your state before adopting it.
Can a coach or athletic director use this without a physician?
You can adopt the template administratively. Return-to-play clearance itself must be signed by the medical professional your state authorizes. For a defensible program, a sports-neurologist review of your final policy is recommended.