Report a Sports Injury
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Date of Injury *
MM
/
DD
/
YYYY
Time of Injury *
時間
:
Venue *
Club Official *
Which Club is the injured person from? *
Injured Person's Full Name *
Your email address *
Status *
Injured Person's Age *
Injured Person's Gender *
Activity at time of injury *
What specific activity were you involved in when the injury occurred? (e.g. heading the ball, tackling an opponent, landing from a jump) *
What was the cause of the injury? (e.g. landing, collision, falling, illness) *
What factors contributed to the injury? (e.g. weather conditions, ground conditions, unsafe equipment, foul play, fatigue) *
What protective equipment was being worn on the body part injured? *
Nature of injury *
Part(s) of the body injured *
What initial treatment was given? *
Your Name *
Your email address *
Severity of injury *
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