Athletics Injury Report
Please fill in all information immediately after an injury.
Name of Person Filling out Report *
Date of Injury *
MM
/
DD
/
YYYY
Time of Injury *
Time
:
Level *
Sport *
Student Athlete's Name *
What school does the student attend? *
Where did the injury happen? *
Which body parts were injured? *
Please check all that apply
Required
Please describe how the injury happened? Be Specific. *
Was EMS called? *
Was a parent notified? *
What date was the parent notified?
MM
/
DD
/
YYYY
What time was the parent notified
Time
:
Submit
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