One Form must be completed by the Skater's Medical Staff or Chief Medical Officer for each injured Skater.

Any copies of laboratory, radiological or medical reports that were conducted in the investigation of the injury/illness is to be sent to by separate email at medical@isu.ch

Reason: (*)
Invalid Input

Name of the Event:(*)
Please type your full name.

Location: (*)
Invalid Input

Date of Injury: (*)

Invalid Input

Discipline:(*)
Invalid Input

Athlete's First Name: (*)
Invalid Input

Athlete's Last Name: (*)
Invalid Input

Athlete Nationality:(*)

Age:(*)
Invalid Input

Gender:(*)
Invalid Input


Diagnosis:(*)
Invalid Input

Contact with:
Invalid Input

(or) Injury type:
Invalid Input

Other:
Invalid Input

Region:
Invalid Input

Problem Status:
Invalid Input

Onset during:
Invalid Input

Other:
Invalid Input


Treatment Modalities:(*)

Invalid Input

Other:
Invalid Input

Medication #1:
Invalid Input

Medication #2:
Invalid Input

Medication #3:
Invalid Input

Medication #4:
Invalid Input

Injury Severity:(*)
Invalid Input

Expected absence:(*)
Invalid Input


Full Name:(*)
Invalid Input

Function/Title:(*)
Invalid Input

(Other):(*)
Invalid Input

E-mail(*)
Invalid Input

Terms and Conditions(*)
Invalid Input