The Concussion Physical Therapy Evaluation Template is a detailed and user-friendly tool designed to assist clinicians in conducting thorough and efficient evaluations of patients who have sustained a concussion. This template provides a structured framework to guide physical therapists through every critical component of the concussion assessment process, ensuring no important aspect is overlooked.

Starting with the patient’s medical and injury history, the template helps clinicians document the mechanism of injury, onset of symptoms, and any prior concussions or relevant medical conditions. It includes sections for detailed symptom tracking, which is crucial for monitoring changes and guiding treatment decisions. The template covers neurological screening, including cranial nerve assessment and cognitive screening to identify areas of dysfunction.

A significant focus of the template is on vestibular and ocular-motor evaluations, which are often affected after concussion. It guides therapists through tests such as gaze stability, smooth pursuits, saccades, and vestibulo-ocular reflex assessments. Balance and gait evaluations are also incorporated, including standardized tests to quantify deficits and track improvement over time.

Cognitive function is another critical area assessed, with prompts to evaluate memory, attention, processing speed, and executive function. The template also allows for the documentation of functional limitations and impact on daily activities, which helps tailor the rehabilitation plan to the patient’s specific needs and lifestyle.

This comprehensive evaluation template streamlines the documentation process, enabling therapists to gather all necessary clinical information in one organized format. It supports consistent, evidence-based practice and facilitates communication with other healthcare providers involved in the patient’s care.

Designed for physical therapists specializing in concussion management, this template enhances clinical efficiency, promotes thorough assessment, and ultimately supports better patient outcomes through personalized and targeted rehabilitation plans. Whether for initial evaluation or ongoing reassessment, the Concussion Physical Therapy Evaluation Template is an essential tool in concussion care.