Every U.S. state and the District of Columbia has a youth-sports concussion law. They share a common core: an athlete suspected of a concussion must be removed from play and may not return until cleared. Each row below states that jurisdiction's specific clearance requirement (who can clear the athlete, any waiting period, and whether a graduated return-to-play protocol is required) with the law name linking to the official rules and a link to the governing statute so you can verify it yourself.
Separate from these laws, US Soccer's concussion initiative sets heading limits nationwide: no heading for players age 11 and under (indirect free kick if deliberate in a game); limited practice heading at ages 12-13 (about 30 min/week, 15-20 headers/player/week); no restriction at 14+. These ages are national policy, not state law.
What varies by state is the concussion return-to-play law in the table below.
| State | Law & official rules | Clearance requirement | Clearance form |
|---|---|---|---|
| Alabama AL | Ala. Code § 22-11E-2 (2011) ↗ | Removed from play and may not return until evaluated by a licensed physician and given written clearance to return by a licensed physician. |
Clearance form ↗ |
| Alaska AK | Alaska Stat. § 14.30.142 (2011) ↗ | Removed from play and may not return until evaluated and cleared in writing by a qualified person, a state-licensed (or licensure-exempt) health care provider or a designee supervised by a licensed physician, who is trained and currently certified in concussion evaluation and management. |
Healthcare-provider release referenced on the ASAA forms page; no direct PDF verified. |
| Arizona AZ | Ariz. Rev. Stat. § 15-341 (2011) ↗ | On a later day, may return only after written clearance from a health care provider (physician, athletic trainer, nurse practitioner, or physician assistant) trained in concussion management. |
No single statewide form; clearance provider-determined. |
| Arkansas AR | Arkansas Act 1435 of 2013 ↗ | May not return until evaluated by a licensed healthcare provider trained in concussion evaluation and management and given written clearance to return. |
No dedicated form surfaced; clearance provider-determined. |
| California CA | Cal. Educ. Code § 49475 (2011) ↗ | May not return until given written clearance from a licensed health care provider trained in concussion management; if a concussion is confirmed, must also complete a supervised graduated return-to-play protocol of at least seven days. |
Clearance form ↗ |
| Colorado CO | Jake Snakenberg Youth Concussion Act (2011) ↗ | May not return until evaluated by and given written clearance from a health-care provider; a licensed athletic trainer may then manage the graduated return to play. |
No standalone form surfaced; clearance provider-determined. |
| Connecticut CT | Conn. Gen. Stat. § 10-149c (2010) ↗ | May not return to activity involving physical exertion until given written clearance from a licensed health care professional trained in concussion management, and may not return to full, unrestricted activity until symptom-free and given a second written clearance. |
Clearance form ↗ |
| Delaware DE | 14 Del. C. § 303 (2011) ↗ | Must receive written clearance on the DIAA Acute Concussion Evaluation and Return-to-Play form from a Qualified Healthcare Provider; clearance into full contact (Stage 5) must come from a QHP not employed by the school, with final clearance after the graduated protocol by a licensed athletic trainer or school nurse. |
Clearance form ↗ |
| District of Columbia DC | Athletic Concussion Protection Act (2011) ↗ | May not return until evaluated by and given written clearance from a licensed or certified health-care provider. |
No downloadable statewide form; clearance provider-determined. |
| Florida FL | Fla. Stat. § 1006.20 (2012) ↗ | May not return until the school receives written medical clearance from the health care practitioner trained in concussion management defined by the FHSAA Sports Medicine Advisory Committee (an MD or DO). |
Clearance form ↗ |
| Georgia GA | Return to Play Act of 2013 ↗ | Must be evaluated by a health care provider and may not return until cleared by a health care provider for a full or graduated return to play. |
Awareness form only; clearance provider-determined. Statute does not expressly require the clearance to be in writing. |
| Hawaii HI | Hawaii Act 197 of 2012 (amended 2016) ↗ | Must be removed from play and may not return until medically cleared by a licensed health care provider trained in concussion management. (Hawaii's law is uncodified; specific provider types and a written-clearance requirement could not be confirmed from an official state source.) |
Clearance handled via Hawaii DOE / HCAMP; no HHSAA form verified. |
| Idaho ID | Idaho Code § 33-1625 (2012) ↗ | May return only after being evaluated and authorized to return by a qualified health care professional trained in the evaluation and management of concussions. |
Clearance form ↗ |
| Illinois IL | Youth Sports Concussion Safety Act (2015) ↗ | May not return until evaluated by a treating physician, athletic trainer, APRN, or physician assistant, has completed the school's return-to-play and return-to-learn protocols, and that provider gives a written statement that return is safe. |
RTP forms left to individual schools. |
| Indiana IN | Ind. Code § 20-34-7 (2011) ↗ | May not return until at least 24 hours have passed and a licensed health care provider trained in concussion management gives written clearance to return. |
Clearance form ↗ |
| Iowa IA | Iowa Code § 280.13C (2011) ↗ | May not return until evaluated by a licensed health care provider trained in concussion management and the school receives written clearance, after a stepwise return-to-play protocol that begins only after at least 24 hours symptom-free. |
Clearance form ↗ |
| Kansas KS | School Sports Head Injury Prevention Act (2011) ↗ | May not return until evaluated by a physician licensed to practice medicine and surgery who gives written clearance (clearance is personal to the physician and may not be delegated). |
Clearance form ↗ |
| Kentucky KY | Ky. Rev. Stat. § 160.445 (2009, amended 2012) ↗ | May not return on the day of injury, and may not return in any later practice or competition unless a physician provides written clearance. |
Clearance form ↗ |
| Louisiana LA | Louisiana Youth Concussion Act (2011) ↗ | May not return until evaluated by a health care provider and given written clearance for a full or graduated return to play. |
Clearance form ↗ |
| Maine ME | Me. Rev. Stat. tit. 20-A § 254(17) (2012) ↗ | May not return to full participation until a licensed health care provider trained in concussion management gives written clearance to begin a graduated return-to-activity protocol (each phase at least 24 hours), per Maine's DOE model policy. |
Clearance specifics live in the Maine DOE model policy (implementing 20-A M.R.S. § 254(17)), not the statute. |
| Maryland MD | Md. Educ. Code § 7-433 (2011) ↗ | May not return until obtaining written clearance from a licensed health care provider trained in the evaluation and management of concussions. |
Clearance form ↗ |
| Massachusetts MA | Mass. Gen. Laws ch. 111 § 222 (2010) ↗ | May not return until one of five authorized providers (a physician; or an athletic trainer, nurse practitioner, physician assistant, or neuropsychologist working with a physician) completes the state's written medical clearance form, after a graduated, symptom-free re-entry protocol. |
DPH Post Sports-Related Head Injury Medical Clearance and Authorization Form, or school equivalent. |
| Michigan MI | Mich. Comp. Laws § 333.9156 (2012) ↗ | May not return until an appropriate health professional gives written clearance; for MHSAA sports the clearance must be unconditional, issued by an MD, DO, PA, or NP, and dated after the day of removal. |
Clearance form ↗ |
| Minnesota MN | Minn. Stat. § 121A.37 (2011) ↗ | May not return until the athlete no longer shows any signs, symptoms, or behaviors consistent with a concussion and a provider trained and experienced in concussion management gives written permission to return. |
Clearance embedded in MSHSL physical-exam form; stepwise protocol via MSHSL. |
| Mississippi MS | Mississippi Youth Concussion Act (2014) ↗ | May return only after full recovery and clearance by a health care provider trained in concussion management (a licensed physician, NP, PA, or supervised licensed professional), and must first show no symptoms in a full supervised practice. |
Information form only; clearance provider-determined. Statute does not expressly require the clearance to be in writing. |
| Missouri MO | Interscholastic Youth Sports Brain Injury Prevention Act (2011) ↗ | Must be held out at least 24 hours and may not return until evaluated by a licensed health care provider trained in concussion management who gives written clearance. |
Clearance form ↗ |
| Montana MT | Dylan Steigers Protection of Youth Athletes Act (2013) ↗ | May not return until the athlete no longer shows signs, symptoms, or behaviors consistent with a concussion and a licensed health care professional gives written clearance that the athlete can safely resume participation. |
No standalone form surfaced; clearance provider-determined. |
| Nebraska NE | Concussion Awareness Act (2011) ↗ | May not return until evaluated by a licensed health care professional who gives written, signed clearance, which the student submits to the school with written parental permission. |
NSAA hosts a clearance form; no direct file URL verified. |
| Nevada NV | Nev. Rev. Stat. § 385B.080 (2011) ↗ | May return only when a parent/guardian provides a signed statement from a provider of health care (physician, PA, APRN, physical therapist, or licensed athletic trainer) that the pupil is medically cleared, and the date of return. |
No standalone form surfaced; clearance provider-determined. |
| New Hampshire NH | N.H. Rev. Stat. § 200:50 (2012) ↗ | May not return the same day, and may return only after a health care provider gives medical clearance and written authorization, plus written parental permission. |
Policy published; no standalone form verified. |
| New Jersey NJ | N.J. Stat. § 18A:40-41.1 (2010) ↗ | May not return until evaluated by a physician or licensed provider trained in concussion management, given written clearance by a physician trained in concussion management, and after completing the CDC six-step return-to-play progression. |
Standardized RTP form referenced; also governed by NJ DOE model policy. |
| New Mexico NM | N.M. Stat. § 22-13-31 (2010) ↗ | May return no sooner than 240 hours (10 days) after the injury, only after symptoms resolve and a licensed health care professional gives a written medical release. |
No standalone statewide concussion form verified; clearance per statute via a written medical release. |
| New York NY | Concussion Management and Awareness Act (2011) ↗ | May not resume activity until symptom-free for at least 24 hours and given written, signed authorization by a licensed physician; for public-school interscholastic play, also clearance from the district medical director (who may, but need not, require a graduated return-to-play progression). |
Clearance governed by NYSED Commissioner's Regulation 8 NYCRR 136.5(d)(2) and the local district medical director. |
| North Carolina NC | Gfeller-Waller Concussion Awareness Act (2011) ↗ | Must complete the full 5-stage NCHSAA return-to-play protocol and be cleared in writing by a Licensed Health Care Provider (physician, athletic trainer, PA, NP, or neuropsychologist), with parent/guardian consent. |
Clearance form ↗ |
| North Dakota ND | N.D. Cent. Code § 15.1-18.2-04 (2011) ↗ | May not return until a licensed, registered, or certified health care provider trained in concussion management gives written authorization, which the school must retain. |
No downloadable form; clearance provider-determined. |
| Ohio OH | Ohio Rev. Code § 3313.539 (2012) ↗ | Cannot return the same day and may not return until given written authorization by a physician (MD/DO), or by a school-authorized provider acting in consultation with, on referral from, in collaboration with, or under the supervision of a physician. |
Clearance form ↗ |
| Oklahoma OK | Okla. Stat. tit. 70 § 24-155 (2010) ↗ | May not return (and not the same day) until evaluated by a licensed health care provider trained in concussion management who gives written clearance to return. |
No dedicated form surfaced; clearance provider-determined. |
| Oregon OR | Max's Law (2009) ↗ | May not return the same day and no sooner than the next day, and only after symptoms resolve and a qualified health care professional gives a medical release (a graduated return-to-participation protocol applies under OSAA guidance). |
Clearance form ↗ |
| Pennsylvania PA | Safety in Youth Sports Act (2011) ↗ | May not return until evaluated and cleared in writing by an appropriate medical professional: a concussion-trained licensed physician, a trained licensed/certified professional the physician designates, or a qualifying licensed psychologist/neuropsychologist. |
Clearance form ↗ |
| Rhode Island RI | School and Youth Programs Concussion Act (2010) ↗ | May not return until evaluated by a licensed physician (who may consult an athletic trainer) trained in concussion management, and given written clearance from that physician. |
Parent-acknowledgement form only; clearance provider-determined. |
| South Carolina SC | S.C. Code § 59-63-75 (2013) ↗ | May not return until given written medical clearance by a physician (an MD or DO licensed in South Carolina). |
Clearance form ↗ |
| South Dakota SD | S.D. Codified Laws § 13-36-9 (2011) ↗ | May not return until the athlete no longer shows signs, symptoms, or behaviors consistent with a concussion and a licensed health care provider trained in concussion management gives written clearance. |
Concussion content bundled in pre-participation packet. |
| Tennessee TN | Tenn. Code § 68-55-502 (2013) ↗ | May not return until evaluated by a health care provider and given written clearance for a full or graduated return to play. |
Info/signature form only; clearance provider-determined. |
| Texas TX | Natasha's Law (2011) ↗ | May not return until evaluated by the treating physician, has completed each step of the district concussion oversight team's return-to-play protocol, and the physician gives a written statement that return is safe. |
Clearance form ↗ |
| Utah UT | Protection of Athletes with Head Injuries Act (2011) ↗ | May not return until a qualified health care provider trained in concussion management gives a written statement (confirming recent concussion training) that the child is cleared to resume participation. |
Clearance form ↗ |
| Vermont VT | Vt. Stat. tit. 16 § 1431 (2011, amended 2013) ↗ | May not return until examined by, and given written permission from, a health care provider (an athletic trainer or other licensed provider trained within the prior five years in concussion management). |
Clearance form ↗ |
| Virginia VA | Va. Code § 22.1-271.5 (2010) ↗ | May not return the same day, and may return only after evaluation by an appropriate licensed health care provider (as defined by the Board of Education) and that provider's written clearance. |
Policy/SMAC forms published; no dedicated clearance PDF verified. |
| Washington WA | Zackery Lystedt Law (2009) ↗ | May not return until evaluated by a licensed health care provider trained in concussion management and given that provider's written clearance (the original Lystedt model law). |
RTP form behind the MyWIAA portal; no direct PDF verified. |
| West Virginia WV | W. Va. Code § 18-2-25a (2013) ↗ | May not return to play or practice until a licensed professional trained in concussion management (MD, DO, DC, ARNP, PA-C, athletic trainer, or PT) gives written clearance. |
Clearance form ↗ |
| Wisconsin WI | Wis. Stat. § 118.293 (2012) ↗ | May not return until evaluated by a health care provider (credentialed and trained in pediatric concussion) and given written clearance from that provider. |
Resources published; no standalone form verified. |
| Wyoming WY | Wyo. Stat. § 21-3-110 (2011) ↗ | May not return until evaluated by a health care provider and given written clearance; for loss-of-consciousness cases, clearance must come from a Board-of-Medicine practitioner. |
Head-injury position statement and Wyoming DOE model policy; no separate clearance form surfaced. |
It depends on the state. Some states require a physician (MD or DO) specifically — for example Alabama, Florida, Kansas, and South Carolina — while many others allow a broader set of trained, licensed health care providers, which may include nurse practitioners, physician assistants, athletic trainers, or neuropsychologists. Find your state's row in the table above for the exact rule.
Almost every state requires removal for the rest of the day and bars same-day return. Several add explicit minimums: Indiana and Missouri require at least 24 hours, New York requires being symptom-free for at least 24 hours, California requires a graduated protocol of at least 7 days once a concussion is confirmed, and New Mexico requires at least 240 hours (10 days) before return.
Many states require a stepwise, symptom-limited return-to-play progression supervised by a trained provider — for example California, Delaware, Illinois, Iowa, Maine, Massachusetts, New Jersey, North Carolina, Texas, and Virginia. Others require written medical clearance without specifying the protocol in statute. Check your state's row in the table above.
These laws were written primarily for public-school interscholastic sports. Whether they extend to private schools, club teams, and recreational leagues varies by state, and many leagues adopt the same return-to-play standards by policy. Confirm coverage with your specific league and state athletic association.
Yes. Dr. Neil J. Patel, MD, MBA, a board-certified sports neurologist, evaluates concussions, treats persisting symptoms after concussion, and provides return-to-play clearance. See concussion care for details.
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Dr. Neil J. Patel, MD, MBA, a board-certified sports neurologist, sees patients for concussion, persisting symptoms after concussion, and return-to-play clearance.
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