ImPACT Testing Release Form 2021-2022
The Athletic Department will continue its implementation of an innovative program for our student-athletes, grades 6-12. This program will assist physicians and athletic trainers in evaluating and treating concussions. In order to better manage concussions sustained by our student-athletes, we have acquired a software tool called ImPACT (Immediate Post Concussion Assessment and Cognitive Testing). ImPACT is a computerized exam utilized in many professional, collegiate, and high school sports programs across the country to successfully diagnose and manage concussions. If an athlete is believed to have suffered a head injury during competition, ImPACT is used to help determine the severity of head injury and when the injury has fully healed.

The computerized exam is given to athletes who have been selected onto a team before beginning contact sport practice or competition. This non-invasive test is set up in “video-game” type format and takes about 15-20 minutes to complete. It is simple, and actually many athletes enjoy the challenge of taking the test. Essentially, the ImPACT test is a preseason physical of the brain. It tracks information such as memory, reaction time, speed, and concentration. It, however, is not an IQ test.

If a concussion is suspected, the athlete will be required to re-take the test. Both the preseason and post-injury test data is given to a local doctor or, to help evaluate the injury. The information gathered can also be shared with your family doctor. The test data will enable these health professionals to determine when return-to-play is appropriate and safe for the injured athlete. If an injury of this nature occurs to your child, you will be promptly contacted with all the details.

We wish to stress that the ImPACT testing procedures are non-invasive, and they pose no risks to your student-athlete. We are excited to implement this program given that it provides us the best available information for managing concussions and preventing potential brain damage that can occur with multiple concussions. The Athletic Department is striving to keep your child’s health and safety at the forefront of the student athletic experience. Attached you can find a document that will explain the ImPACT test further and how your daughter will be tested. You can also visit https://www.impacttest.com/ for additional information on the ImPACT test. Please contact the Athletic Department if you have further questions at 305-446-5673.
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Please note, all participating Carrollton Athletes must be ImPACT tested. It is required that a Testing Release Form be on file prior to the scheduled testing date. Please complete the information below and click submit.
Student Name *
Student Grade (as of Fall 2021) *
Sport(s) Student-Athlete Plans to Participate in *
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