September 21-22, 2010

6:30 PM-7:30 PM

 Once again this year, the Arctic Foxes Hockey Association will be sponsoring baseline testing through the UPMC Center for Sports Medicine that can be used when evaluating the severity of a concussion. There are two sessions this year. The first session will be held on Tuesday, September 21, 2010 and the second session will be held on Wednesday, September 22, 2010. Testing for both sessions will begin at 6:30 and continue till 7:30 PM. The appointments will be setup according to when each player is registered on-line.  John Seibert will coordinate the schedules and will notify each family prior to testing. The first 15 players registered will be tested from 6:30 PM to 7:00 PM; the next 15 players registered will be tested from 7:00 PM to 7:30 PM and this process will continue until all players have been tested.   
     
Below are the forms that can be completed for each participant prior to their testing session.  As long as the forms are completed by the legal parent/guardian, that parent/guardian does not need to attend with their son/daughter and the group can arrange car-pooling.  However, it is best for the 9 and under participants to have someone in the room to assist them with the instructions as they are taking the test. 

The TPO Consent form is for all participants. The Patient Demographic Form is to be completed for kids ages 10 and older.  The Pediatric Demographic Form is for kids ages 5 to 9. Those participants 10 and older will take the regular version of the ImPACT test and those 9 and under will be tested on the pediatric version. From the age of 13 and up, the baseline is taken every other year, under 13 years old they are to take it every year.
 
Baseline testing can also be conducted at the UPMC Bethel Park office on an individual basis, but the charge is $40 per person.
 
I hope this information helps you - getting baseline testing done is a very important process in the management of concussions.
 
Please contact John Seibert at 412-310-2512 with any other questions or concerns.  

UPMC Sports Performance Complex
Center for Sports Medicine

South Side office 

3200 S. Water St.
Pittsburgh, PA  15203 

UPMC Consent for Treatment Form  

UPMC Patient Demographic Form  

UPMC Pediatric Demographic Form  

AFHA Form On Line Registration

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