Skip to content
SafetyCulture
Template

Near Miss, Hazard and Incident Report

by Alan Taylor-Reed, from the Community

Downloads: 0
Get this template

This DOA-19 near miss, hazard and incident report template helps teams capture key details to improve site safety and compliance. Record project number, location and site address, date and time, conditions, and a clear description of the event. Attach photos, note witness and reporter details, and document supervisor review and actions taken. Capture root causes, assign further actions, and track H and S advisor comments. Includes prompts for RIDDOR 2013 reportability and date reported to HSE, supporting UK compliance. Ideal for construction and field operations seeking consistent incident documentation.

With SafetyCulture you can

Digitize any process, procedure or policy
Eliminate mistakes made by paper-based processes
Create and share professional reports instantly
Confirm accountability and compliance with a digital log

With SafetyCulture you can

Digitize any process, procedure or policy
Eliminate mistakes made by paper-based processes
Create and share professional reports instantly
Confirm accountability and compliance with a digital log

About author

Community

This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.