INJURY REPORT FORM

Please use this form for any injury that required assessment from the medic/sports trainer or prevented the player from participating any further in the game/training session.

CONCUSSION:
All concussions - the 2024 WAFC Concussion Notification Form.needs to be completed in addition to this injury form.
At the conclusion of the 21-day concussion period a medical certificate will need to be submitted to the Peel District Competition Management via the 2024 WAFC Concussion Notification Form.before returning to play.

For further information and guidance, please refer to the following links:
WAFC Policy 8: Concussion and AFL Community Concussion Guidelines.

Players name Players name First Last
Players club
Year group
Please select when the injury occurred:
Round Number - Select N/A if the injury occurred at training
Team name
Is the injury ?
Cause of injury
Suspected nature of injury illness: All concussions must complete the 2024 WAFC Concussion Notification Form in addition to this injury form.
Initial management
Referal/Advice given
Please give all details if you selected other in any of the options above
Reporting persons name Reporting persons name First Last
Reporting persons position
Date Date / MM / DD YYYY