Injury Reporting (Milton Minor Hockey)

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Print Injury Reporting

Team/Player Info

Team^*

Select Team from dropdown list. The list is auto-generated from the website to include all teams. Please ensure you have picked correctly!
Player Last Name^*
Player First Name^*
Trainer Attending (Last Name, First Name)^*

Last Name, First Name
Trainer Email^*

Email so you get a copy of this injury form emailed back for your records

General

Date of Injury^*

Open the calendar popup.

Injury Conditions^*

Select from dropdown list.
If Other/Other Sport - Please give details

Give details of when/where the injury occurred.

Injury Description

Injury Description^*

What/how it happened.

Managment of Injury

What was done to Manage the injury^*

Eg. ice/bandage/tape/etc
Continued Care^*
Returned to PlayDid Not Return to PlayEMS to hospitalCar to hosptital or clinic
Select most appropriate statement. Remember, if player requires continued medical care that a Hockey Canada Injury Report must be filled out by the doctor/EMS.

Follow Up/Recommendations

What did you recommend to the player/parents?

Describe any followup to player or parents^*

e.g. recommend to see family doctor, other, etc
Any other Comments?

Someting else you may want to pass along to the Head Trainer.

I agree to the terms and conditions stated above^*

Human Validation

Check The Box ^*