Injury form

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Injury form

If you have sustained an injury during your training session, a match or international tournament with Amsterdam Netball, please fill in this form. The data from this form will be used to monitor injuries in our club, and used to manage and prevent future injuries.

This information will remain confidential and can only be viewed by the Health and Safety Officer and Executive Board of Amsterdam Netball.

Name

Date of injury

YYYY

Did your injury happen during

A training session (drills, fitness, agility, circuit)

Match play

An international tournament

Other:

Clear selection

Where is your injury?

Ankle

Finger

Knee

Other:

Clear selection

How severe is your injury?

Mild (rolled ankle, finger sprain, fall)

Moderate (sprained ankle, muscle strain, concussion, hard fall)

Severe (rupture, fracture, break)

Small cut (with little to moderate blood)

Sizable cut (with a substantial flow of blood)

Other:

Clear selection

Have you received professional medical treatment for your injury, like physiotherapy?

Yes

Other:

Clear selection

Can you still play Netball?

Yes

Clear selection

What was your recovery period before you started playing Netball again?

1-2 weeks

2-4 weeks

3 months

6 months

12 months

Other:

Clear selection

Which position were you playing?

Clear selection

Could your injury have been prevented? If so, what should have been done?

Submit

Clear form

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