MLQ Player Injury Report Form
The following questions pertain only to the injured player's information. Only select questions indicated by (X) will be available to the public for player tracking, but every other response will be used solely for MLQ data analysis.
(X) Player's Team *
(X) Player Name *
Your answer
Date of Injury *
MM
/
DD
/
YYYY
Time
:
(X) Primary Player Position *
Player Position at Time of Injury *
(X) Type of Injury *
Required
Was the information in the question above provided by a medical professional? *
Was the injury due to an illegal play? *
Injury Narrative *
Please describe the events that caused the injury to occur.
Your answer
Response to Injury *
Were emergency personnel contacted? Was the player taken out of play? Did the player return to play? etc.
Your answer
Additional Medical Professional Information *
Players are strongly encouraged see a doctor/specialist after injury, please state their advice or diagnosis. If a medical professional has not been contacted, state "none" below.
Your answer
(X) Estimated Date of Return to Practice *
MM
/
DD
/
YYYY
(X) Estimated Date of Return to Game *
MM
/
DD
/
YYYY
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