Child SCAT5: Sport Concussion Assessment Tool for Ages 5-12
The Child SCAT5 is a standardized tool used by medical professionals to evaluate concussions in children aged 5 to 12 years. It provides detailed instructions for use and highlights the importance of medical assessment and monitoring in case of suspected concussions. This form is designed to ensure proper and safe management of concussion injuries in young athletes.
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How do I fill this out?
To fill out the Child SCAT5 form, begin by completing the patient and examiner details accurately. Follow the steps to assess for red flags, observable signs, and symptom evaluation as outlined in the form. Ensure all steps are completed thoroughly and accurately for proper assessment.

How to fill out the Child SCAT5: Sport Concussion Assessment Tool for Ages 5-12?
1
Complete patient and examiner details.
2
Assess for red flags and observable signs.
3
Perform the Glasgow Coma Scale assessment.
4
Document athlete background and symptom evaluation.
5
Review and save the completed form.
Who needs the Child SCAT5: Sport Concussion Assessment Tool for Ages 5-12?
1
Physicians need this form to assess concussion in young athletes.
2
Licensed healthcare professionals use this form for standardized concussion evaluation.
3
Sports coaches require this form to understand concussion risks.
4
Parents of young athletes use this form to ensure their child's safety after a head injury.
5
Medical facilities use this form for proper documentation of concussion assessments.
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What are the instructions for submitting this form?
Complete the Child SCAT5 form with accurate details and follow the outlined assessment steps. Submit the completed form to the relevant medical professional or facility via mail, fax, or email. Contact your local medical facility for specific submission addresses and guidelines.
What are the important dates for this form in 2024 and 2025?
Not applicable for this form.

What is the purpose of this form?
The purpose of the Child SCAT5 form is to provide a standardized tool for evaluating concussions in children aged 5 to 12 years. It is designed for use by physicians and licensed healthcare professionals to ensure proper assessment and management of concussion injuries. By following the detailed instructions provided, users can accurately document and monitor concussion symptoms, promoting the safety and well-being of young athletes.

Tell me about this form and its components and fields line-by-line.

- 1. Patient details: Includes fields for the athlete's name, date of birth, address, and ID number.
- 2. Examiner details: Includes fields for the examiner's name, date of injury, and time of assessment.
- 3. Immediate or On-Field Assessment: Involves the evaluation of red flags and observable signs, and the Glasgow Coma Scale assessment.
- 4. Athlete Background: Contains fields for athlete background information such as sport, team, school, and concussion history.
- 5. Symptom Evaluation: Includes a symptom checklist to be completed by the athlete and parent/teacher.
What happens if I fail to submit this form?
Failing to submit the Child SCAT5 form may result in improper management of concussion injuries.
- Missed Diagnosis: Without proper documentation, concussions may go undiagnosed, leading to health risks.
- Incomplete Assessment: Failure to assess all sections may result in incomplete evaluation of the concussion severity.
- Delayed Treatment: Delayed submission of the form can delay necessary medical treatment for the athlete.
How do I know when to use this form?

- 1. Suspected Concussion: When a child experiences a head injury and concussion is suspected.
- 2. Baseline Testing: For preseason baseline testing to compare post-injury scores.
- 3. Medical Assessment: To document the findings of a medical assessment after a head injury.
- 4. Concussion Monitoring: For monitoring symptoms over time to detect any changes.
- 5. Return to Play Decisions: To help decide when it is safe for the athlete to return to play.
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How do I share the completed Child SCAT5 form?
You can share the completed form via email or generate a shareable link using PrintFriendly's sharing options.
What is the purpose of the Child SCAT5 form?
The Child SCAT5 form is designed to assess and manage concussions in children aged 5 to 12 years using a standardized approach.
Can I save my progress while filling out the Child SCAT5 form?
Yes, you can save your progress on PrintFriendly to ensure all sections are completed accurately.
Who should use the Child SCAT5 form?
The Child SCAT5 form should be used by physicians, licensed healthcare professionals, sports coaches, and parents of young athletes.
How do I know if I should use the Child SCAT5 or another form?
The Child SCAT5 is for evaluating children aged 5 to 12 years; for older athletes, use the SCAT5 form.
Are there instructions included in the Child SCAT5 form?
Yes, detailed instructions for use are provided on page 7 of the Child SCAT5 form.
Is the Child SCAT5 form free to use?
Yes, the Child SCAT5 form may be freely copied and distributed in its current form for non-commercial purposes.
Can I use the Child SCAT5 form for digital documentation?
Yes, you can use the Child SCAT5 form for digital documentation with specific approval from the Concussion in Sport Group.
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