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Chirurgeon Event Report Form

To be filled out by the Chirurgeon-in-Charge (if only one warranted chirurgeon is present, he/she is considered in charge)
Legal Name: SCA Name:
E-mail Address:
Event Name: Event Date:
Hosting Group: Number of Participants:
Other Chirurgeons present:
Minor incidents (like band-aids and icepacks). Just include the number and the circumstances, if they seem important to mention:
Medium incidents (people who needed more care, but were not sent on to seek further medical care). Describe the incident(s) and the treatment/advice you gave:
Major incidents (people who had to seek further medical care). Describe the incident, the treatment/advice you gave, the findings from doctor or hospital and the patients name and contact information:
Remarks (Any special remarks about this event). Include things like adverse weather conditions or access issues:
Include the email address of anyone besides yourself and the Kingdom Officer who should receive this report. An example might be your Seneschal or a Baronial Officer. Separate multiple addresses with a comma.
Security Code Security Code:    
Æthelmearc is a Kingdom in the Society for Creative Anachronism (SCA), a non-profit educational society dedicated to the recreation of the Middle Ages and Renaissance.

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