NZ Concussion and Serious Injury Report free printable template

CONCUSSION AND SERIOUS INJURY REPORT FORM TEAM MANAGEMENT REPORT/REFEREE REPORT Concussion and Serious injury reports must be completed for the following injuries Any incident that results in a Suspected Concussion. THIS DOES NOT REQUIRE A LOSS OF CONCIOUSNESS. Any head or neck injury that requires the player to be transported directly from the ground to an emergency department hospital or after hours medical centre Any injury that results in the admission of a player into hospital Serious...

How to fill out NZ Concussion and Serious Injury Report

How to fill out NZ Concussion and Serious Injury Report Form

1. Download the NZ Concussion and Serious Injury Report Form from the official website.
2. Begin with the player's details: Full name, age, and contact information.
3. Provide the date and time of the incident.
4. Describe the nature of the injury and how it occurred.
5. Include details about the onset of symptoms and their severity.
6. Document any immediate treatment given at the scene.
7. Record the names of any witnesses present during the incident.
8. Complete any additional sections as required, such as medical evaluations or follow-up actions.
9. Review the completed form for accuracy and completeness.
10. Submit the form to the appropriate authority or organization as specified.

Who needs NZ Concussion and Serious Injury Report Form?

1. The NZ Concussion and Serious Injury Report Form is needed by:
2. Coaches and team managers to report injuries of players.
3. Medical personnel assessing injuries for treatment tracking.
4. Sports organizations for injury monitoring and compliance.
5. Parents or guardians of injured players for documentation purposes.

People Also Ask about

What is an accident report form?

The Accident Book is an essential document for employers and employees, who are required by law to record and report details of specified work-related injuries and incidents.

How do you write an injury statement for work?

Dear [Supervisor Name]: I am respectfully presenting this letter as written notice that I was involved in a work-related accident on [date of incident] at approximately [time of incident]. [I was injured / I became ill] when [give clear details involving the accident, including what led up to it].

How do you write an injury report example?

What should you include in an incident report? When & where did it happen? Your report should contain the date, time and location where the accident took place. Who were involved? What did they do? Why did it happen? Were there any witnesses? What is the extent of damage to a person or property?

What is an example of an injury statement?

I am respectfully presenting this letter as written notice that I was involved in a work-related accident on [date of incident] at approximately [time of incident]. [I was injured / I became ill] when [give clear details involving the accident, including what led up to it].

What is the OSHA form for injury report?

The OSHA Form 300 is a form for employers to record all reportable injuries and illnesses that occur in the workplace, where and when they occur, the nature of the case, the name and job title of the employee injured or made sick, and the number of days away from work or on restricted or light duty, if any.

What is an example of a statement for injury?

I was hurt when I (give details about what happened. For example, whether you were hurt in a fall from a height, slip and fall accident or motor vehicle accident while on the clock, or were injured due to overexertion or something else).

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What is NZ Concussion and Serious Injury Report Form?

The NZ Concussion and Serious Injury Report Form is a document used in New Zealand to formally report incidents of concussion or serious injuries sustained by players in sports activities. It helps ensure that these injuries are documented and managed appropriately.

Who is required to file NZ Concussion and Serious Injury Report Form?

Coaches, team managers, and medical staff are required to file the NZ Concussion and Serious Injury Report Form whenever a player is diagnosed with a concussion or experiences a serious injury during a sporting event.

How to fill out NZ Concussion and Serious Injury Report Form?

To fill out the NZ Concussion and Serious Injury Report Form, the person responsible must provide details about the injured player, the nature of the injury, the circumstances under which it occurred, and any medical treatment received. It is important to be as detailed and accurate as possible.

What is the purpose of NZ Concussion and Serious Injury Report Form?

The purpose of the NZ Concussion and Serious Injury Report Form is to ensure the safety and well-being of athletes by documenting incidents of concussion and serious injuries, which aids in the ongoing monitoring and management of players' health.

What information must be reported on NZ Concussion and Serious Injury Report Form?

The information that must be reported includes the player's name, date of birth, type of injury, date and time of the incident, description of how the injury occurred, and details of medical treatment, if any, received by the player.