Community Baseball Game Injury Report
Game Information
Date of Game
Location
Team
Opposing Team
Injured Person Information
Name
Age
Role
Player
Coach
Umpire
Spectator
Other
Injury Details
Date of Injury
Time of Injury
Injured Body Part(s)
Type of Injury
Describe How the Injury Occurred
Immediate Treatment/First Aid Given
Was Injured Person Taken to Hospital/Clinic?
Yes
No
Name of Medical Provider (if applicable)
Witnesses (if any)
Witness Name(s)
Witness Contact Info
Report Completed By
Name
Role/Position
Contact Info
Date