APPENDIX 2 REGULATION 22 APPENDIX 2. ARTIFICIAL RUGBY TURF INJURY INFORMATION FORM Match: ...................................................... versus ..................................................... or Training: Yes ☐ No ☐ Venue: .................................................... Date/KO Time: ......................................... Referee: .................................................. Conditions: .................................................................................................................. Type of Surface/Manufacturer/World Rugby Preferred Turf Producer: ....................... Player Name: ........................................... Position: .................................................. Nature and Cause of Injury: ........................................................................................ ..................................................................................................................................... ..................................................................................................................................... ..................................................................................................................................... Attention Required: ...................................................................................................... ..................................................................................................................................... ..................................................................................................................................... ..................................................................................................................................... Period of Time Player Unable to Play Rugby: ............................................................. Attending Doctor Name: .............................................................................................. Signed by Union Medical Officer: ................................................................................ (Print Name in Block Capitals) Confirmation by Union official of consent of Player/coach/medical officer to personal information sharing: Signed: ..................................................... Date: ....................................................... Name: .......................................................................................................................... Last update: 14 January, 2015 470
World Rugby Handbook
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