top of page

Wild Rose Paramedic Report

To be completed by the medical personnel that attended the Wild Rose Competition.

Competition Name*

Competition Start Date*

Competition End Date*

Competition Location*

Competition Manager Name*

Competition Manager Email

Competition Manager Phone

Total number of incidents attended to:*

Number of incidents considered major/serious by paramedic:*

Number of incidents in which a concussion was suspected by paramedic:*

Number of incidents where paramedic recommended the athlete withdraw from competition due to severity/nature of injury:*

Name of Attending

Medical Personnel/Report Submitted by:

First name*

Last name*

Signature*

Date Report Submitted*

Medical Personnel Email*

Medical Personnel Phone*

©2025 by Alberta Equestrian Federation

bottom of page