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Kansas KSHSAA Concussion Return to Learn Form

KSHSAA's return-to-learn form helps a Kansas school's concussion management team bring a student back to class safely after a concussion. School medical personnel fill in the injury details and notes for the provider, and after the evaluation the health care provider selects classroom accommodations and restrictions based on a four-step return-to-learn strategy.

Who completes it

The health care provider completes the section after the evaluation date, selecting accommodations and restrictions, and signs. The referring athletic trainer or school medical personnel complete the top section before the exam.

Submitting and payment

How to submit it
The completed form goes back to the school's concussion management team, which includes administrators, teachers, school medical personnel, coaches, community providers and parents.
Who pays
KSHSAA sets no fee and does not say who pays for the evaluation.

Good to know

  • The four steps run from being excused from school with limited daily activity, through part-time and full-time return with accommodations, to normal attendance without accommodations.
  • Students progress when symptoms worsen no more than 2 points on a 0 to 10 scale for under an hour, and should handle normal schoolwork before unrestricted sports.
  • Accommodation boxes include rest breaks, limited screen time, sunglasses or a hat, a quiet space, extra time, class notes and delayed exams.
  • Restrictions can cover PE (walking only), weightlifting, band or music, debate or forensics, and shop classes.

Get the official form

Download the current version from the source each time; forms change without notice.

Concussion Return to Learn Form

Official pagePDF

Fill it with Vero

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A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

Who completes the Kansas Concussion Return to Learn Form?

The athletic trainer or school medical personnel complete the top section before the exam, including notes for the provider. The health care provider completes the rest after the evaluation, choosing accommodations and restrictions, and signs with address and phone.

Do all concussed students need return-to-learn accommodations?

No. The form says not every student who suffers a concussion needs to follow the chart, and many return to learning with little or no difficulty. It is a general strategy for students who may not be able to handle all school demands right away.

How does return to learn relate to return to play in Kansas?

Students should be fully back in the classroom before full sports participation. The KSHSAA return-to-play form adds that academic modifications should not be needed when an athlete progresses to step 4, and the provider can refer to this form there.