2019 Injury Report
To be completed for moderate and major injuries occurring at International competitions
Email address *
Your First and Last Name
Your answer
Please select the competition for which you acted as CRS
Date of Competition
MM
/
DD
/
YYYY
Injured Athlete
First and Last Name
Your answer
Address
Your answer
National Federation
Your answer
Email address
Your answer
Type of Injury
Please describe the injury mechanism
Your answer
Was there a security failure?
Did the Athlete continue to compete?
Final diagnosis
to be completed through MedCom
Your answer
Competition Doctor
First and Last Name
Your answer
Email address
Your answer
Telephone number
Your answer
Signature *
Required
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service