Concussions survey

1.     On a scale of 1to 10 how important do you think preventing concussions are?

                          1   2   3    4   5   6   7   8   9   10

2.     Have you ever played football as a school sport?

                                          Yes/NO

3. Circle your age group.

       13-16 17-21 22-26 27-32 33+

4. Do you think football is a dangerous sport? Yes or No If yes why?

 

 

5. Put in order of importance

__Players protecting their head

__players protecting their arms and legs

__Players protecting their ribs

6. What side of the field do you play or did play?

                            Offence or Defense

7. What was your position on the field?

8. What is your association with football?

Coach, Player, Parent of a player, Team member, Brother of a player/Sis

9. Are you male or female?

10. Have you ever suffered a concussion?

                             Yes/No