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Jefferson School District

Learning Today...Leading Tomorrow

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  • Jefferson School District
  • Head Injury or Concussion

    Has your child sustained a head injury or been diagnosed with a concussion that may affect their academic performance?

    If so, please contact your child's teacher or school nurse immediately. The following forms are recommended for management and safe return to school post head injury. Physician clearance and recommendations are required for safe reintegration into the classroom setting.

    Concussion Information for Students/Families that play Sports:
    CIF Concussion Information English o Spanish
    CIF Graded Concussion Symptom Checklist (complete pre-season for baseline information)

    Checklist for Injuries Sustained at School:
    Concussion Signs and Symptoms Checklist English o Espanol

    Physican Clearance and Recommendations for Returning to School:
    Physician Letter to School after Concussion Visit
    Physician Recommendations & Accommodations for Returning to School

    Standard Protocol:
    Return to Learn Protocol English o Espanol
    Return to Play Protocol English 

Jefferson School District

1219 Whispering Wind Drive Tracy, CA 95377

Phone: 209-836-3388Fax: 209-836-2930

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