Incident/Near Miss Reporting Form

The Incident/Near Miss Reporting Form records an incident or near miss in four sections: who reported it, what happened, the causes, and the follow-up.

It records the date, time and location, 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.

Written by SafetyDocs safety experts, who have been writing safety documents since 2004.