STORM Injury Report
This form is to be used to document any injury that occurs during practice or in a game. Please provide as much accurate information as possible in a timely manner.
Email address *
Date of Injury *
MM
/
DD
/
YYYY
Time of Injury *
Time
:
Practice/Game Location *
Your answer
Team *
Name of Player *
Your answer
Coach Name *
Your answer
Coach Followed Up? *
Injury Description *
Your answer
Severity of Injury *
Minor
Severe
Did the player return to practice/game? *
Did player go to hospital/urgent care/trainer or other healthcare provider? *
A copy of your responses will be emailed to the address you provided.
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