CHC Incident Report Form 
https://www.pitchero.com/clubs/chelmsfordhockeyclub/d/documents.html?group_id=22296
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Email *
Name and location of the facility where the injury took place. *
Name of the captain/coach supervising the game or training session. *
Full name of the injured person. *
Age of the injured person. *
Contact details of the injured person or their parent if under 18. *
Date of the incident. *
MM
/
DD
/
YYYY
Time of the incident.  *
Time
:
Nature of injury, including location on the body. *
Any other after effects including any delayed concussion, headaches, bleeding etc. *
Full details of the incident, including how it happened, what activity was being performed, where it happened. *
Witness name and contact details. *
Action taken including first aid given. *
Police called? *
Ambulance called? *
Welfare Officer informed? *
Did the player seek advice from a GP, doctor, dentist or medical profession after? *
If facilities have been involved in this injury, please ensure that a member of the Management Committee is informed at the soonest opportunity. Please give brief details here of how facilities have contributed to this injury, if applicable. 
If you have used resources from your first aid kit, please list what needs to be repaced. *
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