North Carolina
• The training program must include: written information detailing the recognition of the signs and symptoms of concussions and other head injuries; a description of the physiology and the potential short term and long term effects of concussions and other head injuries; and the medical return to play protocol for postconcussion participation in interscholastic athletic activities.
• All middle schools and high schools must provide a concussion and head injury information sheet on an annual basis to all coaches, school nurses, athletic directors, first responders, volunteers, students who participate in interscholastic athletic activities, and the parents of those students. School employees, first responders, volunteers, and students must sign the sheet and return it to the coach before they can participate in interscholastic athletic activities, including tryouts, practices, or competition. Parents must sign the sheet and return it to the coach before their children can participate in any such interscholastic athletic activities.
• If a student participating in an interscholastic athletic activity exhibits signs or symptoms consistent with concussion, the student must be removed from the activity at that time and shall not be allowed to return to play or practice that day. The student cannot return to play or practice on a subsequent day until the student is evaluated by and receives written clearance for such participation from a physician with training in concussion management, a neuropsychologist with training in concussion management and working in consultation with a physician, an athletic trainer, a physician assistant or a nurse practitioner.
