Accident And Near Miss Reporting Form

Record the date and time of the near miss event.

Accident and near miss reporting form. This general incident report form can be used to report and document accidents incidents near misses or equipment damage involving members of staff. In both cases hazards may be marked as resolved or put in the project s tasks to be resolved. Document the details of the incident including location equipment used and people involved. All accidents incidents and near misses should be reported no matter how trivial they may seem at the time.

Non injury and near miss incident reporting form instructions. In addition you may also add observed hazards. The safesite near miss incident reporting form gives you the option to create an associated hazard. Take photos of any equipment damage.

However an accident report places more emphasis on an injury sustained whereas an incident report focuses more on the cause of an event and how an employer can prevent it in the future. A near miss is a potential hazard or incident that has not resulted in any personal injury or property damage. Please use this form to report all work related injuries diseases ill health and near misses. If you re an employee report near misses to reduce your chances of being injured at work.

It is used by safety teams to perform the following. The terms accident and incident are often used interchangeably. You can complete this form on someone else s behalf for example if the injured person is not able to fill out the form themselves. An accident report or incident report is a form that an employee or manager fills out in the case of an injury illness or near miss at the workplace.

This near miss report template is used to document near miss incidents to mitigate the risk and prevent recurrence. Complete the form immediately after the incident or arrange for someone to do it on your. Near miss report form. Instructions for completing the form.