PLL Preliminary Incident Report


- Incident and Injury Information -

Was First Aid Required?  If so, what?
Was Professional Medical Treatment Required?  If so, What?
Type Ball:

Injured person was:

Position when injured:

Type of Injury:
Injured Body Part:
Cause of Injury:
Were there any witnessess to the accident?  Who/phone #?
Could this accident have been avoided?  If so, how?
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