Post concussion symptoms

The post concussion symptom scale

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The post concussion symptom form

Patients Information ( please complete all of the fields below )

Instructions

Report your current experience of symptoms. After reading each symptom, please select the number that best describes the way you have been feeling today. A rating of 0 means that you have not experiences this symptom today. A rating of 6 means that you have experiences severe problems with this symptom today.

Post concussion symptom form

symptom

none

Mild

Moderate

severe

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