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Coaches Concussion Certification Form

Coach Concussion Certification

I have completed training or an annual update to previous training regarding concussions. Attached to this certification is evidence of my completion of the  required annual training. I understand what a concussion is and what are the common signs, symptoms and behaviors associated with concussion and concussion type symptoms. I agree I will remove an athlete from all team physical activities if a player sustains a concussion or exhibits concussion type symptoms. I understand it is my responsibility to complete a Minnesota Hockey Concussion Reporting and Medical Clearance To Return To Play Form within 48 hours of receipt of information which indicates a player has sustained a concussion or exhibits concussion type symptoms. I understand that I cannot allow a player to return to team physical activities until I have received a completed Minnesota Hockey Concussion Reporting and Medical Clearance To Return To Play Form which is signed by an appropriate health professional and a parent or legal guardian of the player. I understand that knowingly violating the Youth Rules and Regulations can result in
discipline up to and including suspension for up to one year.


  • USA Hockey online age modules
  • The Center for Disease Control:
  • National Federation of State High School Associations:
  • Training provided through other youth sport programs