Referee Feedback Report

DIRECTIONS: Please fill in as many fields as possible. The more information included in this report, the faster the resolution will be for all parties. Moreover, this form includes text boxes to enter narrative, comments and feedback (copy and paste into these boxes, if needed). When you submit this form, the Colorado Referee Committee will receive an instant email report and the report will be used to improve our officiating.

This form should be used for '2nd Level Feedback', only.  For details on the reporting levels, click here .  This Feedback Report is to be used only for games affiliated with US Soccer or US Youth Soccer and registered affiliated Referees.  Please do not submit reports for unaffiliated games such as High School, College.

Thank you for taking the time to make the Colorado Referee Program even stronger.

Reporting Person Information:

Name of Reporting Person: (Required)
Email Address for Reporting Person: (Required)
Phone Number for Reporting Person: (###-###-####)

Game Information:

Home Team Coach  Score
Home Team Coach's email address        
Away Team Coach  Score
Game Date (mm/dd/yyyy format) Game Time    
Location (Complex/Field/Park)        
League Division    
Game Number Age/Gender (i.e., U16G)    
Referee Name (if known)        
Assistant Referee #1 (if known) (Bench Side)      
Assistant Referee #2 (if known) (Far-Side)      

The Referee:

Observations Rating
1. Professional appearance?
2. Thorough pre-game?
3. Worked as a crew/Worked well with assistants?
4. Dealt effectively with substitutes?
5. Recognized Assistant Referee flags/offside calls?
6. Managed the game?
7. The referee used advantage/disadvantage principles?
8. Common sense/Age of players was considered?
9. Demonstrated COURAGE to make a "big call" or big "no call" at the right time?

Comments for the Colorado Referee Committee and Performance Description:

Overall Performance Ratings for the Referee:(Any rating of 0-4 must have a comment in the text box below)

With '0': Low and '10': High, start with your rating at '5' (Acceptable) and rate up or down from there.

Performance Ratings Rating
1. Consistency throughout the game:
2. Penalized "unsafe" plays:
3. Use of advantage/disadvantage:
4. Talked players out of "minor" violations:
5. Proper estimate of 10 yards:
6. Dealt with encroachment:
7. Handled player dissent in a professional manner:
8. Handled coach dissent in a professional manner:
9. Dealt with time-wasting issues:

Comments on Referee's Performance Ratings: (any rating of 0-4 must have a comment)

The Assistant Referees:

Questions Assistant #1
(Team side)
Assistant #2
(Spectator side)
1. Consistently focused on the game at all times?
2. Kept up with second to last defender?
3. Assisted referee in control of the game?
4. Recognized the level/age of the players?
5. Effectively got the attention of the referee, when needed?
6. Fair and consistent enforcement of laws?
7. Correctly ruled on off-side infractions?
8. Reacted well to unusual situations?
9. Correctly ruled on line calls?
10. Maintained control of his/her touchline?

Overall Comments for the Assistant Referees:

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Original design contributed by K. Kevin Aten (2010)