Pacific District Concussion Information Page

Concussion Protocol

The Pacific District has adopted concussion protocol in all its affiliates, and USA Hockey recently added a concussion acknowledgement requirement to its online registration process for all members.

The State of Washington was the first to implement concussion protocol in 2009. The Pacific District concussion protocol meets the requirements of the legislation in Washington for youth sports organizations. In PNAHA, implementation of the protocol includes the following, effective with the 2017-18 season.

• Parents/Guardians: Concussion protocol acknowledgement form must be signed annually.
• Coaches: Concussion protocol acknowledgement form must be signed annually. Note: The USA Hockey CEP and coaching modules meet concussion education requirements in all states throughout USA Hockey, but the annual acknowledgement must still be signed within the Pacific District.
• Concussion Evaluation and Return To Participation Protocol:
  • This form is a tool for coaches, managers and parents when an athlete needs to be evaluated for a potential concussion.  While medical providers do not have to complete this form, it does provide valuable information.  Medical providers may release an athlete using their own discharge paperwork.
  • The new USA Hockey concussion management program Return to Sport criteria has been added to the back of the evaluation and return to participation form.

Protocol Forms:

Parent Form

Coaches Form

Return to Participation Form

Additional Resources

Education and awareness regarding concussions and the need to ensure athletes recover fully from them is a primary focus for both the Pacific District and USA Hockey. All affiliate members are encouraged to take advantage of these and other educational resources.

Online Training: The recommended online course is through the Centers for Disease Control at this link: https://www.cdc.gov/headsup/youthsports/training/index.html.

Educational Materials:

Steve Laing Letter to District March 2017

Education Sheet 10U

Education Sheet 11-18U

Education Sheet Parents

Pacific District Concussion Chronicles March 2017

Pacific District Concussion Chronicles May 2017

Pacific District Concussion Chronicles July 2017

Pacific District Concussion Chronicles August 2017 

Pacific District Concussion Chronicles Daniels Story

For more information regarding the concussion program please contact pdconcussion@gmail.com.