Get Wftda Injury Report

Completing the Wftda Injury Report online is an essential step to ensure that your injury is properly documented and eligible for claims. This guide will walk you through each section of the form, providing clear instructions to help you complete the report accurately and efficiently.

Follow the steps to fill out the Wftda Injury Report online.

1. Click ‘Get Form’ button to access the Wftda Injury Report and open it in the editor.
2. Begin by filling in the date and time of the incident. Be sure to specify whether the time was in the AM or PM.
3. Provide the name of your team, club, or organization, and fill out the address and telephone number in the respective fields.
4. Indicate whether the injured person has other medical insurance by selecting 'Yes' or 'No.' If 'Yes,' enter the name of the insurance company and policy number.
5. Identify the category of the injured person: athlete, official, coach, spectator, employee, volunteer, or other. If 'Other,' please specify.
6. State when the injury occurred - during practice, pre-game, during the game, post-game, while traveling, or other. Fill in if you choose 'Other.'
7. Complete the injured person's information with their last name, first name, middle name, telephone number, employer name, address, and date of birth. Also, indicate their gender.
8. If the injured person is a minor, fill in the guardian or parent’s details, including their last name, first name, address, and telephone number.
9. Select the incident location from options such as competition area, concession area, parking lot, or others as applicable.
10. Specify the body part that was injured using the provided options for clear identification.
11. Describe the nature of the incident by selecting an event type such as slip, fall, collision, or assault.
12. Indicate the disposition of the injured person - whether they were released to someone, taken to a hospital, or received medical attention.
13. Outline the primary injury experienced by the individual, choosing from the list provided.
14. Classify the severity of the injury as non-injury, minor, or serious injury/illness.
15. Provide a detailed description of how the incident occurred. If necessary, attach additional sheets with more information.
16. Include witness information if applicable, by providing their names, addresses, and telephone numbers.
17. Have the coach (who has no relationship with the claimant) sign the report and provide their phone number.
18. After completing all fields, review your information for accuracy. Save your changes, and then choose to download, print, or share the completed form.

Complete your Wftda Injury Report online today to ensure prompt processing of your claim.