When to Refer for Concussion Testing: A Provider Checklist

Use this checklist to decide when an accident patient should be referred for standardized concussion testing.

Refer when any of these continue

Headaches that haven't resolved; dizziness or balance problems; trouble focusing or remembering; light or noise sensitivity; sleep changes; irritability or mood changes; a head strike or a forceful jolt in the crash.

Send to the ER instead when

Headache is getting worse, there is repeated vomiting, a seizure, weakness or numbness, slurred speech, unequal pupils, or increasing confusion or drowsiness.

Make the referral

Use /referral or call 813-709-3771. We schedule testing at your office.

Braintree Health Partners provides diagnostics only. We diagnose. You treat.

Become a provider partner today. Refer a patient or book a 15-minute briefing. 813-709-3771.

Why a checklist helps busy practices

In a busy clinic, deciding whether to refer can depend on who's working that day and how the patient happens to describe their symptoms. A shared checklist makes the decision consistent. It helps new staff know what to ask, gives providers a quick record to review, and makes sure patients with persistent symptoms aren't missed simply because they didn't bring them up.

Questions to ask every accident patient

At intake and at each re-exam, ask about headaches, dizziness or balance problems, nausea, blurred or double vision, light or noise sensitivity, trouble concentrating, memory lapses, slowed thinking, irritability or mood changes, and changes in sleep. Ask whether they hit their head, lost consciousness, or have gaps in memory around the crash. Ask the patient to rate each symptom so you can track change over time.

Patterns that suggest referral

Referral is reasonable when cognitive, vestibular, visual, or sleep symptoms continue beyond the first few weeks, when symptoms are getting worse instead of better, when symptoms are interfering with work, school, or driving, or when family members describe changes the patient doesn't notice. A normal CT from the emergency department doesn't rule out a referral when functional symptoms persist.

When not to refer, and instead send to the ER

Testing is for ongoing symptoms. Patients with a severe or worsening headache, repeated vomiting, seizures, new weakness or numbness, slurred speech, unequal pupils, or increasing confusion need emergency evaluation now, not a scheduled test.

Making the referral

Use the referral form or call 813-709-3771. Include the date and mechanism of injury, the symptoms you've recorded with ratings, relevant history such as prior concussions or migraines, and the patient's contact information. Our team schedules testing at your office and returns a physician-reviewed report.

Keeping the checklist current

Review your checklist with your team every few months, and adjust it based on what patients actually report. Keep a copy in the intake packet and in the EHR template so the questions are asked the same way each time.

Example of a good referral note

"52-year-old driver, rear-ended at a stoplight 3 weeks ago, struck head on headrest, no loss of consciousness. Reports daily headaches rated 5/10, difficulty reading more than a few pages, and light sensitivity at work. Symptoms unchanged since intake. No prior concussion history." A note like this gives the reviewing physician the context needed.

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