ISS - CP Football

Supporting information

Required information

Where possible, please complete this form within 24 hours of injury occurance.

Please note that all questions with an asterix (*) require an answer for the form to be submitted.

OSIICS 13.5 - Orchard Codes

This new version arises from an IOC Consensus Conference in 2019 and is called Orchard Sports Injury and Illness Classification System (OSIICS), with generally three-character codes for injuries and four / five-character codes for illness.

Click here to download OSIICS 13.5 Orchard Codes spredsheet

Support

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Injury Suveilance Study - Submission Form

1. Name of National Team / Country: *
2. Player age: *
3. Eligible impairment for sport: *
3a. Additional impairments / health conditions
4. Sport Classification: *
4a. Classification Profile *
5. Player position *
6. Was the player able to return back to play? *
7. Date of injury onset (dd/mm/yyyy): *
8. Estimated Date of Return to Training/Play (dd/mm/yyyy): *
9. Playing surface: *
9a. Playing surface - Other:
10. In which period of the match did the player get injured? *
11. Process of injury *
11a. If contact
Contact - Other (please specify)
11b. If non-contact
Non-contact - Other (please specify)
12. Side of body injured: *
13. Injury location: *
13a. Injury location category: *
14. Injury classification *
15. Injury Classification Category *
16. Orchard Codes (3 codes) Please see supporting information
16a. Orchard Codes - Further details
17. Is this injury a reoccurrence? *
17a. Date of last injury occurance? (dd/mm/yyy)
18. Did the player require any of the listed options? (select all that apply, and if applicable specify type of scan / imaging ) *
Assisted Devices
Medication
Scan / Imaging (please specify above)
Hospitalisation
Surgery
None of the above
19. Did the player experience a spastic reaction? *
🔘 Name of person completing this form (Given Name, Family Name): *
🔘 Role / position of person completing this form: *
🔘 E-mail address of person completing this form: *
I confirm that I have permission to share the above information with Para Football, and confirm it is correct to the best of my knowledge *