A report must be submitted within 48 hours of each injury.

Injury Location:

If you listed the location as "Other," please explain exactly where the injury happened:

Please indicate what body part(s) were injured (i.e. twisted right ankle, torn left hamstring, one inch gash above right eye, etc):

Was medical help called?

If yes, which number was called?

Were they transported to the hospital or infirmary?

If yes, please specify which location and method of transport were used:

Please describe the nature of the injury and include any further information you feel is needed: