Still having symptoms weeks after a concussion? How to prepare for a follow up visit
Describe lasting symptoms, show how daily life has changed and ask about next steps
Maybe the crash was six weeks ago. The bruises have faded and the scan was normal, but the headaches keep coming back. A work email takes three reads. The grocery store feels too loud and too bright. Friends say you look fine, which makes it harder to explain that you are not.
Your follow up visit is a chance to change that. The first visits after a crash often focus on ruling out a serious injury. A visit weeks later has a different job: finding out what is still in your way, what might be adding to it and what to try next.
This guide shows you how to describe lasting problems, how to show their effect on your days and which questions to ask about further evaluation. A companion article in this section, on what to bring to the appointment, has a printable worksheet for your medicines, past care and questions.
What a follow up visit is for when symptoms last
The CDC says that for most people, concussion symptoms ease within two weeks or so [1]. A 2025 guideline for adults who needed little or no hospital care adds that most people are back to their usual routines in about a month [2]. Its authors also note that as many as 1 in 3 people have symptoms lasting past the 30 day mark that could get in the way of normal life [2]. If you are in that group, you are far from alone, and there are next steps.
Guidelines treat the one month mark as a time to look again. The Living Concussion Guidelines, a regularly updated Canadian guideline for adults, say people with symptoms past one month should be considered for referral [3]. That can include a clinic where several kinds of providers work as a team [3]. The 2022 Amsterdam consensus on sport concussion calls symptoms that last more than four weeks persisting symptoms. It advises an assessment from several angles, ideally by a team [9].
The 2025 guideline notes that people at higher risk of a slow recovery may benefit from extra visits, such as weekly ones during the first month [2]. It suggests a specialty referral if disabling symptoms continue past 30 days, or if first treatments in primary care have not helped [2]. A 2021 guideline written by the VA and the Department of Defense adds one more point. If a symptom appears for the first time after day 30, it suggests looking at that symptom for some other cause [10].
Comparison compiled by Safety Behind the Wheel Foundation
When guidelines suggest a closer look
| Guideline | Time point | What it suggests |
|---|---|---|
| Living Concussion Guidelines (2023) | Symptoms past one month | Consider referral, including to a team clinic |
| Action Collaborative guideline (2025) | First month, higher risk | More visits or a referral |
| Action Collaborative guideline (2025) | Disabling symptoms past 30 days | Consider specialty care |
| Amsterdam consensus (2022) | Symptoms past four weeks | Assessment from several angles |
| VA/DoD guideline (2021) | New symptom after 30 days | Look for other causes of it |
Sources: Living Concussion Guidelines [3]; Silverberg and colleagues [2]; Patricios and colleagues [9]; VA/DoD [10]. Your own care team sets the timing for you.
At the visit, your clinician wants to learn a few things. Which symptoms matter most to you right now? Could poor sleep, neck pain, low mood or a medicine be adding to them? Would another kind of assessment help?
How to describe each symptom clearly
Guidelines ask clinicians to track lasting symptoms with a standard questionnaire at each follow up, until the symptoms improve or level off [11]. Common choices include the Rivermead Post Concussion Symptoms Questionnaire, the Neurobehavioral Symptom Inventory and the symptom scale in the SCAT6, a sport concussion tool [2]. The Post Concussion Symptom Scale is another [4].
You do not need to fill one out at home. Your clinic may hand you one in the waiting room. Still, it helps to know how they work. The Rivermead asks about 16 common problems, from headaches and dizziness to poor focus and light sensitivity [12]. You compare yourself now with how you were before the injury, looking at the last 24 hours [12]. Each problem gets a score from 0, for never had it, to 4, for severe [12]. A last line asks about anything else that is bothering you [12].
You can borrow that approach. Compare with your life before the crash, since everyone has some of these problems at times. Stick to a set window, such as the past week, and rate how much of a problem each one is.
Six details for every symptom
For each problem you plan to raise, jot down:
- When it started, and whether it is better, worse or the same since your last visit
- How often it happens and how long it lasts
- How bad it gets, from 0 to 10 or as mild, moderate or severe
- What sets it off, such as screens, noise, exercise or the time of day
- What eases it, and what you have already tried
- Whether you had it before the crash, and how it feels different now
Mention health problems you had before the crash. The 2025 guideline lists earlier migraine, mental health conditions and past concussions among the things that can raise the risk of a slow recovery [2]. Knowing about them gives your clinician a fuller picture.
Comparison compiled by Safety Behind the Wheel Foundation
Turning a vague complaint into a clear description
| Vague | Clear |
|---|---|
| My head hurts all the time | Headaches 5 days a week, starting mid afternoon, lasting 3 hours, about 6 out of 10 |
| I get dizzy | I feel unsteady in store aisles and hold the cart; it fades 10 minutes after I leave |
| My memory is bad | I lose my place in talks two or three times a day and miss about one task a week |
| I am always tired | After 2 hours of desk work I need to lie down for an hour |
| I am not sleeping | Most nights it takes over an hour to fall asleep, and I wake at 3 a.m. |
Examples are made up. The approach follows standard symptom questionnaires [12, 11].
Ask someone close to you what they have seen. According to the CDC, the injured person, their family and even their health care provider can all miss problems after a concussion [1]. A partner may notice that you snap at the kids more or let phone calls go to voicemail.
Showing how symptoms affect your everyday life
Your clinician also needs to know what the symptoms stop you from doing. The Living Concussion Guidelines note that thinking problems after a concussion can affect work, school and social life [4]. The 2025 guideline ties specialty referral to symptoms that are still disabling, so details about daily life help with that decision [2].
Use function statements
A function statement has three parts: the task, your limit and what happens at that limit. Some examples:
- I can read for about 10 minutes before the words blur and a headache starts.
- As a passenger, I can ride about 20 minutes before I feel sick and need to close my eyes.
- I worked 4 of my usual 8 hours a day this week, and I needed each evening to recover.
- I can cook a simple meal when the house is quiet, but not with the TV on and the kids talking.
Numbers make change easy to see. If you could read for 10 minutes last month and 25 minutes now, that is real progress, even if the headaches still come.
Before and after the crash
Use this table to plan what to say. Fill in only the rows that matter to you, and add your own in the blank rows.
Worksheet from Safety Behind the Wheel Foundation
My daily life before and after the crash
| Area of life | Before the crash | Now |
|---|---|---|
| Work or school | ||
| Reading and screens | ||
| Home tasks and cooking | ||
| Getting around | ||
| Exercise | ||
| Family and social life | ||
| Sleep | ||
Fill in by hand. Keep each answer to one line, with a number where you can.
Imagine a 47 year old grocery store manager who was a passenger when her car was hit from the side. At her six week visit, all she says is that work is hard. Next time she comes prepared. She can work 4 hours before a headache starts, bright store lights make it worse, and she sleeps 10 hours on days off. Now her clinician has a clear problem to treat and a number to track.
Picking your top concerns and writing your questions
Visits can move fast. In a study of 112 recorded U.S. visits, clinicians asked patients to name their concerns in only about a third of them (36%) [5]. When they did ask, they cut in two times out of three, after a median of 11 seconds [5]. Patients who were left to finish needed a median of only 6 seconds to say what brought them in [5]. The study was not about concussion, but the lesson carries over: say your main points first.
Choose your top three
AHRQ, the federal Agency for Healthcare Research and Quality, suggests writing your questions down and picking the three you most want answered [6]. With lasting concussion symptoms, you may have ten problems. Rank them by how much each one disrupts your life, and lead with the top three.
Research supports bringing written questions. A 2015 review of 42 studies looked at question prompt lists, which are printed lists of questions patients can pick from before a visit [13]. When the clinician backed the list, patients tended to ask more questions [13]. Some visits ran longer, and the effects on memory, worry and satisfaction were mixed [13].
Then read from your notes or hand them over. If the talk drifts, it is fine to ask to come back to your list before the visit ends.
Asking about further evaluation
Further evaluation means looking at a symptom more closely, often with a provider who focuses on one area. The Amsterdam consensus names the areas often checked when symptoms persist [9]. They include mental health, vision and eye movements, the neck, the vestibular system (your inner ear balance system), headache disorders and sleep [9].
The 2025 guideline gives examples of specialty care for people with specific needs [2]. These include vestibular rehabilitation for dizziness and balance, cognitive rehabilitation for memory and focus, advanced headache treatment, talk therapy for insomnia and a graded exercise plan [2]. For someone with many symptoms, the guideline says a team clinic that treats single symptoms and overall recovery is usually the best fit [2]. It also strongly recommends screening for mental health conditions. It calls a check at about one month, repeated later for people who still have symptoms, advisable [2].
Scans and thinking tests
The 2025 guideline says not every patient needs a brain MRI or CT, though one may be considered when the symptoms are unusual [2]. The VA/DoD guideline suggests against a full set of memory and thinking tests, called neuropsychological testing, in the first 30 days [10]. It also suggests against computer screening programs for routine diagnosis and care [10].
Detailed testing has a place later on. According to the Living Concussion Guidelines, it may be considered after four weeks when thinking problems limit daily life and have stopped improving [4]. Before that step, problems that can cloud thinking, such as pain, mood changes or poor sleep, should be treated [4]. For any test, AHRQ suggests asking how it is done, how it will feel, how to get ready and how you will get the results [6].
Comparison compiled by Safety Behind the Wheel Foundation
Questions to match each possible next step
| Possible next step | Questions to ask |
|---|---|
| Concussion or brain injury clinic | Who will I see? How long is the wait? |
| Vestibular or vision assessment | What will it check? Could treatment help? |
| Brain scan | What could it show that we do not know now? |
| Neuropsychological testing | Is now the right time? How will results guide my care? |
| Mental health screening | Could stress, low mood or worry be adding to this? |
| Sleep assessment | Could my sleep be making other symptoms worse? |
Based on Silverberg and colleagues [2], the Amsterdam consensus [9], VA/DoD [10] and AHRQ [6].
Making sure you leave with a clear plan
Memory for medical advice is poor even without a head injury. A 2003 review found that people forget 40 to 80% of what clinicians tell them right away [7]. Close to half of what they do recall is wrong [7]. Advice given out loud and in writing is remembered best [7]. If memory is one of your symptoms, plan to write things down or ask someone to do it for you.
Say it back
Teach back is a simple check. You put the plan into your own words, and the clinician corrects anything you got wrong or left out. A 2019 systematic review of 26 studies found that most people who got teach back in those studies learned more about their condition [8]. The method was usually paired with other teaching, so its effect alone is hard to pin down [8]. You do not need to wait to be asked. You can say: Let me repeat this back so I know I have it right.
The Living Concussion Guidelines say concussion teaching should come in written, spoken or picture form [3]. Ask for a printed visit summary, or check your patient portal the same day. If the plan is unclear once you get home, AHRQ suggests calling the office [6].
Checklist before you leave the room
Checklist from Safety Behind the Wheel Foundation
- I named my top three concerns.
- I know what may be causing each main symptom, or what is still unclear.
- I know which tests or referrals are planned and who will arrange them.
- I know what to try at home before the next visit.
- I said the plan back in my own words.
- I have a written summary or know where to find it.
- I know when to come back and which changes mean I should call sooner.
If symptoms get worse before your visit
Do not wait for your follow up if serious new symptoms appear. The CDC advises calling 911, or getting to an emergency room at once, if you notice any of these danger signs [1]:
- Head pain that keeps climbing and will not settle
- Weakness or numbness, poor coordination, convulsions or seizures
- Repeated vomiting
- Slurred words or odd behavior
- Pupils (the dark centers of the eyes) that do not match in size
- Failing to recognize loved ones or surroundings, or turning restless, agitated or confused
- Fainting, heavy drowsiness, or someone cannot wake you
Questions to ask your care team
Question checklist from Safety Behind the Wheel Foundation
- Which of my symptoms concerns you most, and which do you expect to improve on their own?
- Could sleep, neck pain, mood or a medicine be adding to my symptoms?
- Can we use the same symptom questionnaire at each visit to track my progress?
- Am I at higher risk of a slow recovery, and should I be seen more often?
- Would a concussion clinic or another specialist help me, and how do I get a referral?
- Do I need any tests now, and how would the results change my treatment?
- Should I be checked for anxiety, low mood or stress after the crash?
- What can I safely do at work and at home while I recover?
- What signs mean I should phone the office before my next appointment?
Frequently asked questions
What if I feel fine on the day of my appointment?
Concussion symptoms can swing from one day to the next. Describe your typical week and your worst day, and bring notes so you do not have to rely on how you feel that morning. Standard questionnaires ask you to compare yourself with how you were before the injury, which helps on good days too [12].
Is it too late to ask for a referral months after the crash?
Guidelines say that people whose symptoms last past one month should be considered for referral [3]. If you have struggled for several months, that is a strong reason to raise it now. Help is available at any stage of recovery.
The bottom line
Recommendation from Safety Behind the Wheel Foundation
A follow up visit weeks after a concussion is your chance to show what is still in your way. Describe each symptom with the same few details, translate it into daily tasks and lead with your top three concerns. Ask what further evaluation could help, and say the plan back before you leave. Timing, referrals and coverage differ by clinic and health plan, so check with your own care team and plan about what fits your situation.
Sources and further reading
- 1Centers for Disease Control and Prevention. Symptoms of mild TBI and concussion. Updated September 15, 2025. cdc.gov/…/signs-symptoms/index.html
- 2Silverberg ND, Lee K, Mikolić A, et al. Action Collaborative on Traumatic Brain Injury Care: adapted clinical practice guideline. Annals of Family Medicine. 2025;23(6):552-569. doi.org/10.1370/afm.250352
- 3Living Concussion Guidelines (Ottawa Hospital Research Institute). Management of prolonged symptoms. Updated April 2023. concussionsontario.org/…/management-of-prolonged-symptoms
- 4Living Concussion Guidelines (Ottawa Hospital Research Institute). Cognitive difficulties. Updated May 2023. concussionsontario.org/…/cognitive-difficulties
- 5Singh Ospina N, Phillips KA, Rodriguez-Gutierrez R, et al. Eliciting the patient’s agenda: secondary analysis of recorded clinical encounters. Journal of General Internal Medicine. 34(1):36-40. Published online July 2, 2018. doi.org/10.1007/s11606-018-4540-5
- 6Agency for Healthcare Research and Quality. Be more engaged in your healthcare (Questions Are the Answer). Content last reviewed November 2024. ahrq.gov/…/questions-before-appointment.html
- 7Kessels RPC. Patients’ memory for medical information. Journal of the Royal Society of Medicine. 2003;96(5):219-222. doi.org/10.1258/jrsm.96.5.219
- 8Yen PH, Leasure AR. Use and effectiveness of the teach-back method in patient education and health outcomes. Federal Practitioner. 2019;36(6):284-289. pmc.ncbi.nlm.nih.gov/articles/PMC6590951
- 9Patricios JS, Schneider KJ, Dvorak J, et al. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport, Amsterdam, October 2022. British Journal of Sports Medicine. 2023;57(11):695-711. doi.org/10.1136/bjsports-2023-106898
- 10U.S. Department of Veterans Affairs and Department of Defense. VA/DoD clinical practice guideline for the management and rehabilitation of post-acute mild traumatic brain injury, version 3.0. Provider summary. 2021. healthquality.va.gov/…/VADoDmTBICPGProviderSummaryFinal508.pdf
- 11Living Concussion Guidelines (Ottawa Hospital Research Institute). Diagnosis/assessment of prolonged symptoms. Updated April 2023. concussionsontario.org/…/diagnosis-assessment-of-prolonged-symptoms
- 12King N, et al. Rivermead Post Concussion Symptoms Questionnaire (form). Journal of Neurology. 1995;242:587-592. Hosted by WSIB Ontario. wsib.ca/…/mtbi_rivermead.pdf
- 13Sansoni JE, Grootemaat P, Duncan C. Question prompt lists in health consultations: a review. Patient Education and Counseling. 2015;98:1454-1464. ro.uow.edu.au/ahsri/651
This article reflects the safety priorities of concussion recovery and road safety education. It offers general education, not medical advice, and it cannot replace a conversation with your own care team. Guidelines change over time, so check official sources and ask a qualified professional about your situation. Reviewed October 2026.
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