Each student who is removed from practice or competition for a head injury or suspected concussion, or loses consciousness, even briefly, or exhibits signs and symptoms of a concussion, shall obtain and present to the Athletic Director, unless another person is specified in school policy or procedure, a Department Post Sports-Related Head Injury Medical Clearance and Authorization Form (Medical Clearance and Authorization Form), or school-based equivalent, prior to resuming the extracurricular athletic activity. This form must be completed by a physician or one of the individuals as authorized by 105 CMR 201.011(A). The ultimate return to play decision is a medical decision that may involve a multidisciplinary approach, including consultation with parents, the school nurse and teachers as appropriate.

1. (A) Only the following individuals may authorize a student to return to play:

   1. (1) A duly licensed physician;
   2. (2) A duly licensed athletic trainer in consultation with a licensed physician;
   3. (3) A duly licensed nurse practitioner in consultation with a licensed physician;
   4. (4) A duly licensed physician assistant under the supervision of a licensed physician; or
   5. (5) A duly licensed neuropsychologist in coordination with the physician managing the student's recovery.
2. (B) Physicians, nurse practitioners, physician assistants, licensed athletic trainers, and neuropsychologists providing medical clearance for return to play shall verify that they have received Department-approved training in post traumatic head injury assessment and management or have received equivalent training as part of their licensure or continuing education.