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WRFC Injury Reporting Form (HRFU)
The club is currently required by Hampshire RFU  to report any relevant injury sustained during training or matches. Please report any injuries by completing the form below.

Note: these are any injuries that have removed the player from the game and subsequent training sessions/games during 21/22 season.

Details of reported injuries are recorded to the club's welfare officer and Hampshire Rugby Safe Lead. For more information, you can contact Christine Donald <csdonald@mac.com>.

* A record will be kept in the team managers slack channel.


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First Name *
What is the inured players first name?
Last Name *
What is the inured players last name?
Date of Injury *
When did the injury happen?
MM
/
DD
/
YYYY
Type of Injury *
Describe the type of injury
Match (M) or Training (T) *
Did the injury occur during a Match (M) or Training (T)?
Contact or Non Contact *
Did the injury occur during Contact or Non Contact?
Days out of action *
Who many days out of action is anticipated?
Which Age Group do you represent? *
Required
Reported by *
Please note the name of who is reporting this injury including your role (Team Manager, Coach, First Aider etc).
Reporters email address *
Please note your email address in case we need to follow up on your report.
Parents informed *
Parent or guardian are aware of this injury and return to play protocols?
Any comments?
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