Report an injury - Smartkidz, Girton, Cambridge

Fill out the form below to let us know if your child will be attending a Smartkidz setting with an existing injury.

Existing Injury

Name of child

First

Last

Today's date

Date injury occurred

Name of Smartkidz setting

Name of person informing the setting

First

Last

Relationship of person to the child

How did the injury happen?

Are there any visible marks, bruises or injuries (describe size, shape, colour and location)?

Was treatment given?

Was medical advice sought (include GP surgery or hospital details)?

Additional information or comments

Signature of person providing the information

If you are human, leave this field blank.