WLMHA Injury Reporting Form (West Lincoln Minor Hockey)

Print WLMHA Injury Reporting Form
Teams are to complete this submission to WLMHA should any injury occur at a WLMHA game, practice or event where a participant is unable to return to the ice in a timely manner. This is NOT the official Hockey Canada Injury Report that needs to be completed. This is an internal notification of injury only.
Injury Information
Please provide the information to the WLMHA regarding what injury happened, where, when and to whom in this brief submission section.
  1. Please provide if this information is known at the time of completing this form. This would specifically refer to what happened at the rink. Example answers: player sent to hospital, player went home with parent, player will seek medical followup, player was bandaged and continued to play, coach that was injured has to leave the ice and rest in the dressing room
Form Submission
Please provide the contact information for the person completing this form.
  1. i.e. Novice Rep - Trainer
  2. Example: [email protected] Your submission will be sent to this address.
Human Validation
Printed from westlincolnwrath.ca on Saturday, April 20, 2019 at 4:15 AM