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Injury Reporting Form

Last updated - 18th May 2026

Stokesley Hockey Club – Injury Reporting Form

Stokesley Hockey Club - Injury Reporting Form

In order to collect meaningful data, England Hockey requires clubs/associations to complete an online ‘Injury Monitoring Form’ following injuries sustained that require one or more of the following:

  • Treatment from a first aid specialist (e.g. Team doctor/ first responder)

  • Hospital treatment

  • Subsequent visit(s) to a GP

5. Where did this injury take place?
Adult Match
Junior Match
Adult Training
Junior Training
Other
6. Who was injured?
Adult Player - Male
Adult Player - Female
Junior Player - Male
Junior Player - Female
Other
7. Did the injury occur during a penalty corner or open play?
Penalty Corner
Open Play
Other
8. Did this injury cause a concussion?
Yes
No
Unsure
9. If yes, to the above question - did they receive or follow any Return to Play advice?
Yes
No
Unsure
10. What was the injury caused by? If other, please specify
Ball
Stick
Person
Other
11. Did the injury require hospital treatment or first aid? If other, please specify
Hospital treatment
First aid
No treatment needed
Other
12. Which part of the body was affected?
13. What was the type of injury sustained? If other, please specify
14. What, if any, protective equipment was being worn at the time of injury? If other, please specify
None
Face mask
Gum shield
Shin pad
Gloves
Other
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