Youth Concussion Club & School Reporting Form

For a confirmed concussion or where the player has been removed from the field of play

Please fill out the form below asap because club need to contact the school or college within 48 hours of injury where possible.

If you have any questions please contact Karen: [email protected] or 07787 802645

Player Information

Type in where the player was at the time where the injury occurred.

Parent/Guardian Contact Information

Other RFU organisation to be notified

Reporting Volunteers Information

For further information or a refresher on head injuries visit the England Rugby website by clicking on the following link: HEADCASE