Near Miss Report Form

A comprehensive Near Miss Report Form is crucial in identifying potential hazards before they result in actual incidents. Here’s how our template aids in creating a safer work environment:

1. Detailed incident documentation

The form provides a structured format for recording the details of the near miss, including when and where it occurred, the personnel involved, and a description of the event. This comprehensive documentation aids in understanding the root cause and implementing corrective actions.

2. Risk identification and evaluation

The form prompts the reporter to identify and evaluate the risks associated with the near miss. This risk assessment is essential in prioritising safety enhancements and preventing similar incidents in the future.

3. Corrective action proposals

The form encourages the reporter to suggest corrective actions, promoting a culture of proactive safety where all employees contribute to hazard mitigation.

4. Sign-off and follow-up

The form includes a section for supervisor sign-off and follow-up actions, ensuring that each reported near miss is thoroughly investigated and addressed.

Insite transforms the way you manage near miss reporting, making it more efficient, accurate, and actionable. Our digital tools bring safety management into the digital age, ensuring that no near miss goes unaddressed.

Real-Time Reporting

Our digital platform enables instant reporting of near misses, ensuring swift response and corrective action. This immediacy can make all the difference in preventing actual incidents.

Centralised Record-Keeping

All near miss reports are securely stored and easily accessible, facilitating analysis, audits, and continuous improvement of safety protocols.

Universal Accessibility

Reports can be accessed, completed, and reviewed from any location, ensuring seamless communication, prompt action, and a unified safety culture.

Completing the Near Miss Report Form is essential in documenting and addressing potential hazards. Here’s a step-by-step guide:

Step 1: Document the incident

Provide a detailed description of the near miss, including the date, time, location, and individuals involved.

Step 2: Identify risks

Describe the risks associated with the near miss and assess their potential impact on personnel and operations.

Step 3: Propose corrective actions

Based on the identified risks, suggest suitable corrective actions to prevent similar incidents.

Step 4: Obtain sign-off

Submit the form for sign-off by a supervisor or safety officer to ensure that the proposed actions are implemented and the near miss is properly addressed.