MALONE SPORTS MEDICINE ImPACT TEST ...
MALONE SPORTS MEDICINE
2600 Cleveland Ave., Canton, OH 44709 Office: 330-471-8297 Fax: 330-471-8298
ImPACT TEST INSTRUCTIONS Go to: www.impacttestonline.com/testing Please note: This test will take approximately 20-30 minutes to complete. Once you begin the test you CANNOT stop and restart at a later time. It MUST be completed all at once. To take the ImPACT baseline test, please follow the steps below: 1. Type the Customer Code in the white box: A8974ED2A7. 2. When the prompt appears, click “Launch Baseline Test” Please Note: You MUST allow pop-ups for this site in order to take the test.
3. Select the language you are most comfortable with in which to take the test from the drop down menu.
4. Read the instructions CAREFULLY so that you fully understand the test and testing environment prior to beginning the test. At the bottom of the page select the unit of measurement you would like to use throughout the test.
5. Familiarize yourself with the test components.
6. Input your demographic information: Name Date of Birth Height Weight Gender Handedness (which hand do your write with) Please note: do not select ambidextrous unless you can write with your right and left hands equally well.
7. Input your Contact information Address Country Email
8. Select your native country (the country in which you were born/raised) and language. Only choose a second language if you are FLUENT in that language.
9. Input Ethnicity information (this is optional)
10. Select your years of education. Note: this does not include kindergarten or the year you are heading into. It only includes years you have COMPLETED. 12= college freshman 13= college sophomore 14= college junior 15= college senior 11. Check any of the education options that apply to you and note what type of student you are. Above Average = A/B Student Average = B/C Student Below Average = C/D Student 12. Select your main sport. Noting position is optional. 13. Select current level of participation 14. Years of experience at that level includes only years completed. 0= freshman 1= sophomore 2= junior 3= senior
15. Note past concussion history to the best of your knowledge. 16. If you have suffered a concussion in the past the number inputted will prompt an additional list of questions to appear. Please answer these to the best of your ability.
17. List the dates (month/year) of your 5 most recent concussions. If you have no history of concussion please leave this page blank and continue to the next page.
18. Indicate previous history of treatment for all issues noted.
19. Mark yes or no as to whether you have been diagnosed with any of the conditions listed.
20. Note to the best of your knowledge you’re most recent concussion date. If you have no previous history of concussion, please leave the date blank. 21. Note the number of hours you slept last night. 22. Please list ALL medications (prescription and over the counter) you are currently taking. This includes inhalers, supplements, etc…
23. You are now done with the demographics section.
24. Throughout the symptom section, please note the level of each symptom you normally feel on a daily basis. Note: 0 being the least and 6 being the most.
25. At this point you will begin the actual test. Please read ALL instructions carefully so that you know exactly what will be expected from you for each section.
26. Once your test is complete the following screen will appear. You may choose to print a test confirmation for your own records. You do NOT need to do anything further to notify us of your test. Your test will automatically be added to our account for us to view. We will access your test to be sure you passed your baseline when we check off your other sports medicine paperwork.
2600 Cleveland Ave., Canton, OH 44709 Office: 330-471-8297 Fax: 330-471-8298
ImPACT TEST INSTRUCTIONS Go to: www.impacttestonline.com/testing Please note: This test will take approximately 20-30 minutes to complete. Once you begin the test you CANNOT stop and restart at a later time. It MUST be completed all at once. To take the ImPACT baseline test, please follow the steps below: 1. Type the Customer Code in the white box: A8974ED2A7. 2. When the prompt appears, click “Launch Baseline Test” Please Note: You MUST allow pop-ups for this site in order to take the test.
3. Select the language you are most comfortable with in which to take the test from the drop down menu.
4. Read the instructions CAREFULLY so that you fully understand the test and testing environment prior to beginning the test. At the bottom of the page select the unit of measurement you would like to use throughout the test.
5. Familiarize yourself with the test components.
6. Input your demographic information: Name Date of Birth Height Weight Gender Handedness (which hand do your write with) Please note: do not select ambidextrous unless you can write with your right and left hands equally well.
7. Input your Contact information Address Country Email
8. Select your native country (the country in which you were born/raised) and language. Only choose a second language if you are FLUENT in that language.
9. Input Ethnicity information (this is optional)
10. Select your years of education. Note: this does not include kindergarten or the year you are heading into. It only includes years you have COMPLETED. 12= college freshman 13= college sophomore 14= college junior 15= college senior 11. Check any of the education options that apply to you and note what type of student you are. Above Average = A/B Student Average = B/C Student Below Average = C/D Student 12. Select your main sport. Noting position is optional. 13. Select current level of participation 14. Years of experience at that level includes only years completed. 0= freshman 1= sophomore 2= junior 3= senior
15. Note past concussion history to the best of your knowledge. 16. If you have suffered a concussion in the past the number inputted will prompt an additional list of questions to appear. Please answer these to the best of your ability.
17. List the dates (month/year) of your 5 most recent concussions. If you have no history of concussion please leave this page blank and continue to the next page.
18. Indicate previous history of treatment for all issues noted.
19. Mark yes or no as to whether you have been diagnosed with any of the conditions listed.
20. Note to the best of your knowledge you’re most recent concussion date. If you have no previous history of concussion, please leave the date blank. 21. Note the number of hours you slept last night. 22. Please list ALL medications (prescription and over the counter) you are currently taking. This includes inhalers, supplements, etc…
23. You are now done with the demographics section.
24. Throughout the symptom section, please note the level of each symptom you normally feel on a daily basis. Note: 0 being the least and 6 being the most.
25. At this point you will begin the actual test. Please read ALL instructions carefully so that you know exactly what will be expected from you for each section.
26. Once your test is complete the following screen will appear. You may choose to print a test confirmation for your own records. You do NOT need to do anything further to notify us of your test. Your test will automatically be added to our account for us to view. We will access your test to be sure you passed your baseline when we check off your other sports medicine paperwork.
