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HRLAX Concussion/Injury Reporting
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Email
*
Your email
Player Name -
Your answer
Team
Your answer
Game or Practice
Your answer
Date
MM
/
DD
/
YYYY
Type of Injury
Your answer
How did injury occur
Your answer
Expected date of return
MM
/
DD
/
YYYY
Email of Coach
Your answer
A copy of your responses will be emailed to the address you provided.
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