Who can give medical clearance to return to contact or risk of falls?

A medical doctor or nurse practitioner. The final decision is based on their clinical judgment, taking into account the athlete's past medical history, clinical history, physical examination findings and the results of other tests and consultations where indicated.

• To progress to step 4 of the Return-to-Sport Strategy, the athlete must give their coach a Medical Clearance Letter stating that a medical doctor or nurse practitioner has personally evaluated them and cleared them to return to sport.
• Before step 4 the athlete must also have successfully completed all steps of the Return-to-School Strategy (if applicable) and steps 1 to 3 of the Return-to-Sport Strategy.
• In rural, remote or northern regions with limited access to medical doctors, a licensed healthcare professional such as a nurse with pre-arranged access to a medical doctor or nurse practitioner can provide this documentation.
• The athlete or coach should also give the information to sport organization administrators responsible for injury reporting and concussion surveillance, where applicable.

Source: https://parachute.ca/wp-content/uploads/2019/06/Concussion-Guideline-2024.pdf