Exit

Question Title

* 1. Gender

Question Title

* 2. Age at time of injury

Question Title

* 3. Describe the injuries (ex. ‘I had swelling to my knee and I had a laceration to my arm that required sutures in the emergency department, had x-ray of my arm and knee but no broken bones’ and ‘I fell and had residual back pain and saw my primary care doctor, who ordered an MRI. I went to physical therapy’)

Question Title

* 4. Describe the scenario leading up to the injury (ex. ‘Another player’s mallet struck my arm during ride off’)

Question Title

* 5. When did the injury occur?

Question Title

* 6. In what setting did the injury occur?

Question Title

* 7. Did your injury require medical attention?

Question Title

* 8. If admitted to the hospital, how many days where you admitted?

Question Title

* 9. What safety equipment were you wearing at the time? (check all that apply)

Question Title

* 10. What brand/model of helmet where you wearing?

Question Title

* 11. Was your horse injured?

Question Title

* 12. What was your USPA Affiliation at the time of injury?

Question Title

* 13. Number of years playing polo at time of injury

Question Title

* 14. How many hours do you play per week on average

Question Title

* 15. What level of polo were you playing at the time of the injury?

Question Title

* 16. Are you willing to be contacted to discuss any other injuries?

T