NCDA Injury Reporting
NOTE: No need to fill out this form if you cc'd the League email.

Any Injuries incurred during a match, practice, or club related activity must be reported to the League even if the injury didn't occur as a result of playing dodgeball.

For many schools and gyms, it is required to report injuries, and most schools have specific injury reports for these situations. The League email can be CC’d on these reports in order to help cut back on the extra paperwork.

Minor injuries are not required to be reported, but may be filed at the Official or Team's discretion. These generally include: minor bloody hands, bloody fingers, scrapped knees, or minor finger/joint jams do not necessarily necessitate Injury Reports. The Official and Team should use their best judgement in if an injury is minor enough.

CONFIDENTIALITY: Names of players and any names of hospital or treatment centers will be kept Confidential and redacted in any possible future publishing of this data.

Date of Incident *
MM
/
DD
/
YYYY
Player Team *
Your answer
Player Name *
Player's Name will be kept confidential.
Your answer
Player Age
Your answer
Location of Incident *
Examples: "GV Gauntlet: GVSU vs CMU" or "BGSU practice"
Your answer
Incident - Type of Location *
Injury *
Examples: "Torn ACL" "Spiral fracture of humerous" "Displaced fracture of proximal phalanx on right pinky finger"
Your answer
Description of Incident *
Examples: "Torn ACL during normal practice play" "Finger hit head on by a dodgeball thrown. Occurred at practice."
Your answer
Action Taken *
Examples: Any action or remedies taken "Received X-rays, had surgery the next day"
Your answer
Additional Notes
Your answer
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