Exit 2022 USPA Player Injury Report Question Title * 1. Gender Male Female Other Question Title * 2. Age at time of injury 18 & Under 19-25 26-35 36-45 46-55 56+ 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? Riding/exercising Stick and balling Practice USPA Tournament Game I/I Game/Tournament Club/League Game Other (please specify) Question Title * 6. In what setting did the injury occur? Grass Field Arena Track/Riding Area Other (please specify) Question Title * 7. Did your injury require medical attention? No Yes, I was seen in a clinic or urgent care setting only Yes, I received on-site medical attention, but did not got to the hospital Yes, I was transferred to the emergency department but discharged from the emergency department Yes, I was admitted to the hospital and stayed overnight for an admission Question Title * 8. If admitted to the hospital, how many days where you admitted? Not admitted 1 2 3-5 6-10 11+ Question Title * 9. What safety equipment were you wearing at the time? (check all that apply) Helmet Goggles/Glasses Helmet mounted eye protection Other (please specify) None of the above Question Title * 10. What brand/model of helmet where you wearing? Question Title * 11. Was your horse injured? No Yes (please specify) Question Title * 12. What was your USPA Affiliation at the time of injury? Registered Player Member (US Citizen) Affiliate Player Member (Non- US Citizen) Social Non-Playing MEmber Not a USPA Member Other (please specify) Question Title * 13. Number of years playing polo at time of injury 0-5 years 6-10 years 11-20 years 21-30 years 31-40 years 40+ years Question Title * 14. How many hours do you play per week on average 0-5 hours 6-10 hours 11-20 hours 21-30 hours 31-40 hours 40+ hours Question Title * 15. What level of polo were you playing at the time of the injury? Junior Polo Intercollegiate/Interscholastic Polo Outdoor (0-4 Goal) Outdoor (6-8 Goal) Outdoor (10-14 Goal) Outdoor (16-20 Goal) Outdoor (22+ Goal) Arena (0-3 Goal) Arena (3-6 Goal) Arena (6-9 Goal) Arena (12+ Goal) Other (please specify) Question Title * 16. Are you willing to be contacted to discuss any other injuries? No Yes (please provide email address) Done