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2016 Female Football Injury Report
Please provide as much information as possible, as the WAWFL and WAFC would like to keep records of all injuries that occur and provide data to the AFL to assist in the research of Females in collision sports and support the research on prevention of injuries for Female Footballers. For additional information please visit: http://tinyurl.com/jw65uyp
Date of Game
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/
DD
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YYYY
Venue of Game
Your answer
Player's Footyweb Number (ID Number on Team Sheet)
Your answer
Players DOB
MM
/
DD
/
YYYY
Player's Club Name
Your answer
Division
Your answer
What type of Injury
Your answer
Reason for Presentation of Injury
Type of Activity at Time of Injury
Approximate Time & Quarter of Injury
Your answer
Nature of Injury/Illness
Cause of Injury
Explain exactly how the incident occurred
Your answer
Were there any contributing factors
Was any protective equipment worn
Initial Treatment
Medical advice given? (eg. return to play, unable to return to play)
Your answer
Referral
Provisional severity assessment
Who Provided Medical Advice
If the player obtained a concussion as per the new Concussion Policy they are not to go back on the field and they are required to submit a medical clearance before being eligible to return to play. Has the player been informed of this
Full name of person Submitting form
Your answer
Role at the Club
Your answer
Qualification
Your answer
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