Incident-Near Miss Report Form
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Value pack · 21 templatesPart of Pest Control Combo
Incident-Near Miss Report Form
Form · FORM-31207
- Version 1
The Incident-Near Miss Report Form records an incident or near miss: who reported it, what happened, the contributing factors and the follow-up actions.
It covers the reporter's details, the type and severity of the incident, up to four witnesses, the immediate and underlying causes, the actions taken and those still required, with the risk control options from elimination to PPE.
Written by SafetyDocs safety experts, who have been writing safety documents since 2004.
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What it covers
7 fields
- Name of witness
- Phone
- Risk control options
- Action required
- By whom
- When
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