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Run: Athletic Injury Report and Emergency Action Plan Activation Log

Track an athletic injury, the immediate response, and whether the emergency action plan was activated. Use it to document school or sports-program incidents ...

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Submission Notice

Reporter name (required)

Reporter role (required)

I understand this form collects limited PII for incident documentation and follow-up. (required)

Yes No N/A

Submission type (required)

Use anonymous submission only if your program allows it and you do not need to identify the reporter.

Injured Athlete Information

Athlete name (required)

Team or activity (required)

Age or grade

Collect only the detail your program needs for follow-up.

Parent or guardian notified? (required)

Incident and Injury Details

Date of incident (required)

Time of incident (required)

Location (required)

Activity during injury (required)

Injury type (required)

Incident description (required)

Describe what was observed, what the athlete reported, and the sequence of events.

Immediate Response and Emergency Action Plan

Immediate response taken (required)

Was the emergency action plan activated? (required)

Reason for EAP activation (required)

Were emergency medical services called? (required)

Transport method

Witnesses and Follow-Up

Witness names

Follow-up actions needed

Additional notes

Include only relevant facts needed for the audit trail and follow-up.

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Email (required)

Your name (optional)

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