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Kentucky KHSAA GE80 Concussion Return to Play

Under KRS 160.445 and KHSAA policy, only an MD or DO may authorize a Kentucky athlete's return to play once a concussion is diagnosed or presumed. Form GE80, adapted from the CDC Acute Concussion Evaluation care plan, records that decision for sports and physical education, based on that day's evaluation and after the required stepwise protocol.

Who completes it

A medical doctor or osteopathic physician completes the form, initials each recommendation selected and signs. The athlete's name, birth date and date of injury are entered at the top.

Submitting and payment

How to submit it
The written authorization goes to the school administration, which then notifies the coach of the permission to return to practice or play.
Who pays
KHSAA sets no fee and does not say who pays for the physician's evaluation.

Good to know

  • Return to play must be based on that day's evaluation and may not be issued for resumption at a future date.
  • The stepwise protocol has six stages, from no activity to normal game play, and KHSAA recommends each stage last at least 24 hours.
  • At an event lasting several days, the designated event physician has final authority, and return cannot come before the third day after diagnosis.
  • The physician also marks whether the athlete may return to PE class and can set a date for a follow-up visit.

Get the official form

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

Concussion Return to Play Authorization

Official pagePDF

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Frequently asked questions

Can a nurse practitioner or PA sign KHSAA GE80?

No. The form is headed Must be signed by M.D./D.O., and it states that under KRS 160.445 only an MD or DO may authorize return to play once an athlete is deemed concussed. The provider checks medical doctor or osteopathic physician in the provider section.

Can GE80 clear an athlete to return on a future date?

No. The return to play must be based on that day's evaluation and cannot be issued based on resumption at a future date. The physician can instead clear the athlete now, clear with restrictions, or mark not cleared and set a return visit.

Who receives the KHSAA GE80?

KHSAA policy says the MD or DO authorization must be in writing to the school administration. The administration then notifies the coach of the permission to return to practice or play. KHSAA also recommends that no athlete return to play before being cleared to return to school.