SCAT Forms Suite
World Standard Concussion Assessment Tools
Important Notes
- •All fields auto-calculate scores where applicable
- •Export completed assessments as PDF for medical records
- •Forms follow the latest 2023 Consensus Statement standards
Child SCAT6 Assessment Form
Sport Concussion Assessment Tool - For Children Aged 5-12
Child SCAT6
Sport Concussion Assessment Tool
For Children Aged 5–12 Years
Ask the child: "Do you have any of these problems right now?" Rate each: Not at all (0), A little bit (1), Somewhat (2), A lot (3)
Not at all
A little bit
Somewhat
A lot
I have a headache
I feel pressure in my head
My neck hurts
I feel sick to my stomach
I feel dizzy
I have blurry eyes
I have trouble with my balance
Lights bother me
Noise bothers me
I feel slowed down
I feel like I'm "in a fog"
I don't feel right
It is hard to pay attention
I forget things
I feel tired
I get confused
I feel drowsy
I feel more emotional
I feel grumpy
I feel sad
I feel nervous or worried
Total Symptoms:0 / 21
Severity Score:0 / 63
Orientation (Score 0 or 1 for each)
What month is it?
What is the date today?
What day of the week is it?
What year is it?
What time is it right now? (within 1 hour)
Orientation Score: 0 / 5
Immediate Memory
Immediate Memory Score: 0 / 30
Concentration
Concentration Score: 0 / 5
Firm Surface (errors out of 10)
mBESS Total Errors: 0 / 30
Tandem Gait (seconds)
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