HEMA Alliance

Activities Injury Log

HEMAA Activities, Specific

This form is for Traumatic Injuries that occur during an official registered HEMAA Activity or Event where Medical Staff/advice is sought, either immediately or after. It is up to each Activity to appoint someone to make sure all Traumatic Injuries are reported. Tournament/Event EMT Staff can also use this form to log their information.

Address of Activity
Date of Activity
Name of Injured Participant
DOB of Injured Participant
Name of Submitter (if different from Injured)
Is the Injured Participant a HEMAA member?
What area of the Body was affected? (check all that apply)
Please be as specific as possible.
Level of On-Site Care
Was follow up care recommended?