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How to use or fill out the Concussion and Serious Injury Report Form

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by filling out the 'Injured Person' section. Clearly print the surname, first names, date of birth, gender, contact phone number, team name, playing position, and grade.
  3. Move to the 'Injury Specifics' section. Select the type of injury from options like concussion or fracture. Specify the on-field treatment provider and site of injury by checking appropriate boxes.
  4. Indicate the phase of play during which the injury occurred and how the player left the field. Use 'Other' fields for any additional details.
  5. Complete the 'Reporting Person's Details' section with date, time, place, name, signature, designation, and contact information.
  6. Finally, attach any relevant accident reports such as those from hospitals or referees before submitting your form.

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