Rowan's Law - Removal From Sport - Record (Port Dover Minor Baseball)

Rowan's Law - Removal From Sport - Record

When a participant is removed from sport due to a concussion or suspected concussion then the designated person shall record the incident and continue to report all training, practices, games etc that are missed due to this removal from sport. Please ensure that this form is submitted for the original incident and subsequent future events the participants misses waiting to return TO sport

Port Dover Minor Baseball - Rowan's Law - Removal From Sport Record Form

Once Completed it will be automatically Emailed to the Executive

Please Use the Describe incident comment box for the following:

FIRST REPORT - the Initial incident description - Enter the full description of the incident
SECOND AND SUBSEQUENT REPORTS - To mark the form as a follow up - This is for submission of missed games and practices due to Concussion protocols - Enter Follow Up
FINAL REPORT - To Submit a return to sport medical letter - Enter Returning to sport. Attach a copy of the medical letter in the return for sport section.

Player Information, Incident record

Complete this section for the initial incident. If this is a follow up for future events missed waiting on Return TO Sport use the same form, but put "Follow Up" in the Describe Initial Incident box

Player Name:^*

Required

Team^*

Required

Date of Incident^*

Required

Location of Incident^*

Required

Describe Initial incident^*

Required

If this is follow up for missed future events awaiting a Return to Sport enter "Follow Up"