Head injury and concussion information for schools, school staff, coaches, athletic trainers, and volunteers

Regulatory guidance to schools, required forms, and required trainings

A concussion is a type of traumatic brain injury (TBI) caused by a bump, blow, or jolt to the head or body that causes the head and brain to move quickly back and forth. In school aged children, many of these brain injuries can occur during a sports practice or event.

Since 2011, Massachusetts has required public schools and schools affiliated with the Massachusetts Interscholastic Athletic Association (MIAA) to develop an interscholastic head injury safety program for grades 6-12 if they have extracurricular athletic activities. These head injury safety programs must include standardized procedures for concussion management and return to play plans for students who sustain head injuries during extracurricular athletic activities. By having concussion policies and procedures in place, schools can prevent further injury or even death from a concussion, and protect the health and safety of their students.

Regulations on head injuries and concussions in extracurricular activities

The regulations known as Head Injuries and Concussions in Extracurricular Athletic Activities provide guidance to school administrators, athletic directors, coaches, certified athletic trainers, medical providers, school nurses, parents and students on their roles in implementing sports concussion management programs in their schools. Please follow the link below to read the full regulations:

• 105 CMR 201: Head Injuries and Concussions in Extracurricular Athletic Activities (PDF) | (DOC)

Required yearly reporting for schools

Year end reporting form

The Year End Reporting Form for Schools is required for all public schools and other schools subject to the rules of the Massachusetts Interscholastic Athletic Association (MIAA) with extracurricular athletic activities for grades 6-12. This form is required to be submitted to the Department of Public Health.

The deadline to submit the 2022-2023 Year End Report is June 30, 2023.

Schools can complete either the online form or downloadable form of the Year End Report. Completing the online form is strongly encouraged.

Please complete the Year End Report for 2022-2023 using the following links:

• Online form: https://redcap.link/SC_YER_2022_2023
• Paper form: Year End Report for 2022-2023 (PDF) | (DOCX)

Letter of affirmation

The school or school district shall provide the Department of Public Health with an affirmation on school or school district letterhead that it has reviewed and updated its policies in accordance with the regulations by September 30th, every two years on the odd numbered year for review or revision of its policies.

Required forms for schools with extracurricular sports activities

The Pre-participation form must be filled out by the student and parent prior to the beginning of every sports season and reviewed by the coach and school nurse to ensure that it is safe for the student to play in school sports.

• Pre-participation Head Injury/Concussion Reporting Form For Extracurricular Activities (PDF) | (DOC)

The Report of Head Injury Form should be filled out when a student has had a suspected head injury during or outside of extracurricular athletic activities.

• Report of a Head Injury During Sports Season Form (PDF) | (DOC)

The Post Sports-Related Head Injury Medical Clearance and Authorization Form should be filled out by a medical provider authorized to allow a student diagnosed with a concussion to begin a graduated return to play protocol, or to clear them for full participation in athletic activities.

• Post Sports-Related Head Injury Medical Clearance and Authorization Form (PDF) | (DOCX)

You can also download Arabic, French, Haitian-Creole, Portuguese, Somali, Spanish and Vietnamese translations of each form.

DPH approved annual trainings

Regulations require that schools must provide Annual Trainings for coaches, school nurses, school and team physicians, certified athletic trainers, athletic directors, marching band directors, student athletes and their parents.

The following annual training programs listed below meet the requirements of the regulations:

• Center for Disease Control and Prevention Heads Up Concussion in Youth Sports On-Line Training Program (available online and free of charge)
• National Federation of State High School Associations Concussion in Sports - What you Need to Know (available online and free of charge)
• CDC Written Course Script and Quiz
• Concussion Training for Coaches - English
• Concussion Training for Coaches - Spanish (PDF)
• Final Written Quiz for Coaches - English (PDF)
• Final Written Quiz for Coaches - Spanish (PDF)

See other options for in-person annual trainings.

Technical assistance

DPH can provide guidance and recommendations to schools on their concussion policies as well as educational materials and resources to support the health and safety of their students. Please contact [e-mail] for more information.

Additional materials: Guidance for schools

• Head Strong: Guidance for Implementing Mass. Regulations on Head Injuries & Concussions in School Athletics (PDF) | (DOC)
• Revised Update to Head Strong, Effective August 1, 2014 (PDF) | (DOC)
• MDPH Guidance on 504 or IEP Plans for Students Returning to Academic Work (PDF) | (DOC)
• Stop Addiction PDF Brochure (PDF) | (DOC)
• Stop Addiction PDF Brochure - Spanish (PDF) | (DOC)