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TF Serious Injury Form
Serious Injury Form
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Introduction
The following is intended to be the procedure to be followed in the event of a serious injury on the pitch, and to provide guidance on some of the issues which may arise following such an injury.
Reporting the Incident
1. The referee should complete a Referee Society Injury Event Form, a copy of which is attached to this document. The report should :- i) include a short factual summary of what happened ii) record details of the teams, team captains, touch judges, referee, coaches, any medical staff and, if possible, relevant spectators iii) not contain any speculation, opinion or guess work iv) be in the referee’s own words and should reflect the language used by the referee v) record if the captains’ score cards were submitted to the Referees Society
2. It is important that the referee records the event whilst it is clear in his/her mind. If the referee has any concerns about completing the report or requires assistance, he/she should not hesitate to contact the local Society Secretary.
3. If the referee receives any communications from third party lawyers, these should be sent directly to his/her local society, for onward transmission to the RFU Legal Officer. The injured party’s advisors will often approach various sources seeking to obtain information such as the Club, individuals, the Referees’ Society and/or the referee, and therefore any correspondence or telephone calls received from lawyers representing injured parties should be referred to the RFU’s Legal Officer.
Name of Injured Player
*
Team He/She Plays For
*
Alnwick RFC
Ashington RFC
Berwick RFC
Blyth RFC
Border Park RFC
Gosforth RFC
Medicals RFC
Morpeth RFC
Newcastle Ravens RUFC
Newcastle University RFC
North Shields RFC
Northern FC
Northumbria University MRU
Novocastrians RFC
Percy Park RFC
Ponteland RFC
Prudhoe & Stocksfield RUFC
Seghill RFC
Tynedale RFC
Wallsend RFC
West End RFC
Whitley Bay Rockcliff RFC
Home Team Name
*
Home Team Coach's Name
*
Home Team Captain's Name
*
Away Team Name
*
Away Team Coach's Name
*
Away Team Captain's Name
*
Date of Match
*
Level of Match
*
Factual Summary of Incident
*
Touch Judge's Names
Add
Remove
Medical Staff Names
Name
Contact Details
Add
Remove
Names of witness /spectators
Name
Contact Details
Add
Remove
Referee's Name
*
Date
*
Name of Person Completing this Form
*
Role at Club/County/School
*
Your Email Address
*
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Northumberland Rugby
Northumberland RFU Clubs
Alnwick RFC
Ashington RFC
Berwick RFC
Blyth RFC
Border Park RFC
Gosforth RFC
Medicals RFC
Morpeth RFC
Newcastle Ravens RFC
Newcastle University RFC
Northern FC
Northumbria University MRU
North Shields RFC
Novocastrians RFC
Percy Park RFC
Ponteland RFC
Prudhoe & Stocksfield RUFC
Seghill RFC
Tynedale RFC
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Play Together, Stay Together
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