concussion protocol

Roseville Premier has one priority and that is the safety of our players. We adhere strictly to the CalNorth and Norcal Premier guidelines set forward in the 2018 mandatory concussion protocols.

Visit the CAL NORTH or Norcal Premier Concussion Protocol Page to learn more.

The Concussion Notification Form is to be filled out in duplicate and signed by a team official of the player’s team. The document should be emailed to: MedicalClaims@calnorth.org.

If a parent/legal guardian of the player is present, have the parent/legal guardian sign and date the Form, and give the parent/legal guardian one copy of the completed Form. If the parent/legal guardian is not present, then the team official is responsible for notifying the parent/legal guardian ASAP by phone or email and then submitting the Form to the parent/legal guardian by email or mail.

When the parent/guardian is not present, the team official must make record of how and when the parent/legal guardian was notified. The notification will include a request for the parent/legal guardian to provide confirmation and completion of the Concussion Notification Form whether in writing or electronically.

The team official must surrender the player pass to a League representative upon injury. The player pass will not be returned until a Medical Release has been received by CalNorth. League must send copy of Medical Release to: 

Cal North Main Office

1040 Serpentine Lane, Suite 201

Pleasanton, CA 94556).

Players may wear their jersey, but must not be in full uniform until the League has received the Medical Release and the pass has been returned to the team official.