ImPACT Testing 9:00am July 18, 2019
Please fill out this form Completely
Email *
Child's Name *
Grade School Year '19 - '20 *
Has this child had a baseline ImPACT Test Before? *
Contact Information (email) *
Contact Emergency Phone number in case of computer lab issues and testing needs to be cancelled.
I hereby give Hudson Memorial School my permission to administer ImPACT Baseline Concussion Testing (Official Electronic Signature of Parent/Guardian) *
A copy of your responses will be emailed to the address you provided.
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