[Type here] TORONTO CATHOLIC DISTRICT SCHOOL BOARD CONCUSSION PROTOCOL 2014
TCDSB FORM SIX
End of Step 6 – Return to Physical Activity
If at any time during the following steps symptoms return, parents must complete
and return Form Eight “Return of Symptoms”.

Student can participate in all physical activities including games with
full body contact.
My child/ward is symptom free after participating in sport-specific physical activity. My
child/ward will proceed to Step 7 – Return to Physical Activity.
Parent/Guardian Signature:
Date:
Comments:
This form indicates student has completed Step 6 at school, is symptom free and
is able to start Step 7 “Return to Physical Activity”.
N.B. It is not required but parents may wish to check with the student’s doctor
before signing this form.
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