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 charliebrown@sru.org.sg
Referee/Medic Name *
Your answer
Referee/Medic email address *
Your answer
Competition Name
Date incident occurred
MM
/
DD
/
YYYY
Teams Involved
Your answer
Venue & Kick Off time
Your answer
Player Name *
Your answer
Player Number
Your answer
Team Name
Your answer
Was a medic present at the fixture?
If yes to the question above, was the blue card recommended by the medic?
Please provide a short write up of the reason for issuing the Blue Card.
Your answer
Please provide any additional information that may be relevant, e,g, coaches disputing decision, medical support, etc.
Your answer
Submit
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