PDFL Handbook 2021 - 2022

FA Medical Emergency Action Plan Form

Club name: Club address:

Name(s) and telephone numbers of First Aider(s): 1. 2. 3 Names and telephone numbers of Facility Manager / Safety Officer:

Location of Club first aid room:

Location of defibrillator:

Location of first aid kit:

Location of stretcher:

Access routes:

For ambulance into Club:

From pitch to ambulance:

From Club ’ s first aid room to ambulance:

Nearest Hospital Emergency Department:

Directions:

Distance / Journey time: Nearest Hospital Neurological Unit (for head Injuries):

Directions:

Distance / Journey time: Nearest Minor Injuries Unit / Walk In Centre:

Directions:

Distance / Journey time:

* A map of the site identifying location of medical facilities and ambulance route attached. Copyright © Football Association 2014