Injury Report Form

 

Please use this form to report any injuries you experienced in the past year.

 

Please enter your Player ID I forgot my ID again

 

1.      When did the injury occur?

Playing on course - Tournament

Playing on course Recreational

Practicing on a course

Practicing off a course

 

2.      Was the injury?

A New injury

A Previous injury from disc golf

A Previous injury from other

 

3.      What were you doing when the injury occurred?

 

 

 

Throwing from a tee (Complete this section):

Concrete

Grass

Dirt

Mulch

Other

Tee condition (Complete this section):

Level

Unleveled

Smooth

Rough

Intact

Damaged

Tee Damaged (explain):

Throwing from the fairway

Throwing from the rough

Putting

Walking/standing on the course

Other:

 

3a. If the injury occurred while throwing, what type of throw was it?

Not applicable

Backhand

Forehand

Overhead

Roller

Other:

 

4. Site of injury? (please check all that apply)

Head

Face

Neck

Shoulder

Upper arm

Lower arm

Elbow

Wrist

Hand

Fingers

Abdomen

Back

Pelvis

Upper leg

Lower leg

Knee

Ankle

Foot

Toes

Other:

 

5. Severity of injury?

Minor - if able to return to practice/game in which injury occurred

Mild if missed one week

Moderate if missed two weeks

Severe if missed more than two weeks

 

6. What is the primary cause of the injury? (pick one)

Course condition

Fitness level

Improper warm-up

Clothing (jacket, shoes, etc.)

Equipment (disc, bag, marker, basket)

 

Unsafe lie

Non-courteous play

Unknown

Other:

 

7. Was weather a factor?

No

Wet

Hot

Cold

 

8. Was tobacco in use when the injury occurred?

Yes

No

 

9. Was alcohol or other drugs in use when the injury occurred?

Yes

No

 

10. What was the most serious injury?

Muscle Strain

Ligament (joint) sprain

Abrasion/scratch/bruise/cut

Broken bone

Concussion

Other:

 

11. Who evaluated the injury? (Check all that apply)

Self

Fellow player

Athletic trainer

Massage therapist

Physical therapist

Chiropractor

Family doctor

Emergency Room

Other:

 

Additional Comments: