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Concussion Report (Blue Card) (2020)
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* Indicates required question
Player's first name and last name
*
Your answer
Player's Union
*
Your answer
Player's Number
*
Your answer
Player's NZ Rugby number (if known)
Your answer
Playing Position *
*
Choose
Loosehead Prop
Hooker
Tighthead Prop
Lock
Blindside Flanker
Openside Flanker
No 8
Half Back
1st 5/8
2nd 5/8
Centre
Left Wing
Right Wing
Fullback
Player's Grade
*
Your answer
Player's Team
*
Your answer
Official's first name and last name
*
Your answer
Official's email
*
Your answer
Official's Union
*
Your answer
Venue
*
Your answer
Date
*
MM
/
DD
/
YYYY
Nature of the offense
*
Give a short description of the law
Your answer
Period of the match when the concussion occurred
*
Choose
1st half
2nd half
Elapsed time in half
Your answer
Brief description of how injury occurred and why card was issued
*
eg. knocked out/dazed/unable to answer questions
Your answer
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