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Near Miss Reporting Form Template

Near Miss Reporting Form Template

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Near misses are hazards that don't result in injury or damage but have the potential to do so. When there's an unsafe act or condition in your workplace, it's important to remove it as soon as possible so a near miss doesn't turn into a full-blown incident. This Near Miss Reporting Form template is a free download that you can use to make sure you record all the necessary data to track near misses in your workplace.

This editable template can be customized to the needs of your organization. With this near-miss form, you'll be able to correct potential hazards and prevent future workplace incidents.

Download this Near Miss Reporting Form template to streamline your approach to tracking near misses in your workplace.

Record near misses such as:

  • Unsafe acts
  • Unsafe conditions
  • Unsafe equipment
  • Unsafe use of equipment
  • and other health and safety concerns

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