| From: | ___________________________ |
| Date: |
___________________________ |
|
(note: This form is not to be used for minor scrapes, cuts or abrasions requiring a simple bandage or two. It is only for more severe injuries requiring immediate medical attention.) |
|
HIKE LEADERS: Start gathering this information at the accident/injury
scene if possible. Fill out this form ASAP. Email the completed forms to
and keep originals in the club notebook under the
“Accident/Injury Forms” tab.
|
| (1) | Hike leader’s name. |
| (2) | Name of the injured person. |
| (3) | Names of at least three witnesses to the accident/injury. Please include a copy of the Trip Release Form. |
| (4) | Date and time of the accident/injury. |
| (5) | Location of the accident/injury—trail name and GPS coordinates if
available. If you have a GPS track with the location marked, please include it. |
| (6) | Nature of the accident or injury (fractures, cuts, puncture wounds, etc.). |
| (7) | What was done to help the injury victim? |
| (8) | Was medical evacuation necessary? |
| (9) | If so, where was the injury victim evacuated to? |
| (10) | Take several pictures of the accident/injury scene and the specific
treatment area, without showing the injury victim’s face if possible. |
|
updated January 15, 2020 |
© Copyright 2020 Arizona Trailblazers. All rights reserved. |
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