EDHLL Injury Reporting Form
Managers, to report an injury (or near miss), please complete the short form below.
The Safety Officer will contact the player's parent/guardian or the adult involved, complete the injury tracking form, determine if further action is needed (such as quarantine in the case of COVID-19, physician's note for return to play, etc.) and communicate the results of this conversation back to you.
Thank you for helping EDHLL continue to prioritize the safety of our players, volunteers and community!
Sarah Preiss-Farzanegan, M.D., EDHLL Safety Officer
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Email *
Your name (first and last) *
Your phone number (the Safety Officer will call you as mentioned above) *
Incident Date *
Time the incident occurred (approximate time is ok) *
Field name/location where incident occurred *
Injured person is *
Injured person's name: *
Injured person’s phone number (parent/guardian if child): *
Brief description of injury (or near miss): *
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