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ImPACT Testing 9:00am July 18, 2019
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Email
*
Your email
Child's Name
*
Your answer
Grade School Year '19 - '20
*
6th
7th
8th
Has this child had a baseline ImPACT Test Before?
*
Yes
No
Contact Information (email)
*
Your answer
Contact Emergency Phone number in case of computer lab issues and testing needs to be cancelled.
Your answer
I hereby give Hudson Memorial School my permission to administer ImPACT Baseline Concussion Testing (Official Electronic Signature of Parent/Guardian)
*
Your answer
A copy of your responses will be emailed to the address you provided.
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