FGHA Concussion Research Study
Thank you for contributing to our concussion research study to better understand the causes of concussions in youth hockey. You may skip a question or quit at any time if you do not feel comfortable answering. This data will be collected anonymously and contains no identifying information.
What organization does the player play for? Example: FGHA
What is the player's year of birth?
What is the player's approximate height and weight?
What is the player's level and division?
At what age did the player start playing hockey?
Has the player suffered a hockey-related concussion?
If answer is no, please proceed to the end and hit submit.
How many concussions has the player suffered? Please list, including approximate dates.
Please answer the following questions about the most recent hockey-related concussion the player has suffered.
What position was the player playing during the incident?
What zone did the incident happen in?
Which direction was the player skating?
What part of the head was impacted?
What kind of collision was it?
Head with the ice
Head with the boards
Head with a player
Where was the puck when the incident occurred?
The player was carrying it
The player collided with the puck carrier
Please provide any additional detail that you think is relevant... (eg. what caused the incident, was there a penalty called on the play, etc.)
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