Support clear, consistent recording following a bump or head injury with this practical two-page Head Injury Monitoring Form, designed for nurseries, preschools, childminders and other early years settings.
 
The first page provides space to record the child’s details, how the injury happened, the location of the bump and the initial assessment. It also includes a clear red-flag symptom checklist, the outcome, further comments and practitioner and parent signatures.
The second page provides a structured monitoring table so practitioners can record regular observations, including whether the child is alert, responsive, walking and talking normally, vomiting, reporting a headache or showing any other visible changes.
 
The form includes
Child’s name and date of birth
Date, time and location of the injury
Details of how the injury occurred
Location-of-bump checklist
Initial assessment checklist
Red-flag symptom checklist
Record of first aid and parent notification
Outcome and further-comments section
Practitioner and parent signature fields
Detailed ongoing monitoring table
Space for dates, times, observations and staff initials
Two printable A4 pages
Suitable for
Nurseries
Preschools
Childminders
Out-of-school clubs
Early years and childcare settings
Digital product information
 
This is a digital download only. No physical item will be posted.
You will receive a printable PDF that can be downloaded and printed whenever required. For best results, print on A4 paper at 100% or actual size.
 
Important information
This form is designed only to support the ongoing monitoring of a child’s health and wellbeing following a head injury.
It should be used alongside your setting’s usual accident or incident form, which should record the full circumstances of the accident, including how and where it happened, any witnesses, first aid provided, actions taken and a body map showing the location of the injury.
This monitoring form does not replace your setting’s accident procedures, first-aid training, professional judgement or medical advice. Where a child displays concerning symptoms, their condition changes or staff are uncertain about their wellbeing, appropriate medical advice or emergency assistance should be sought.