SRU Blue Card Report
This form is to be used by Referees or Medics involved in JRCS and MOE Schools competitions as part of Singapore Rugby's Recognise and Remove and Graduated Return to Play protocols.

The information shared below shall be used by Competition Managers to ensure that the protocols are being followed as part of the players welfare.

If you have any further questions please email Charlie Brown at
Referee/Medic Name *
Referee/Medic email address *
Competition Name
Date incident occurred
Teams Involved
Venue & Kick Off time
Player Name *
Player Number
Team Name
Was a medic present at the fixture?
Clear selection
If yes to the question above, was the blue card recommended by the medic?
Clear selection
Please provide a short write up of the reason for issuing the Blue Card.
Please provide any additional information that may be relevant, e,g, coaches disputing decision, medical support, etc.
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