Template

MCDGRPNZ See Say Do Hazard Report

by Chris Haefele, from the Community

10+

Use the MCDGRPNZ See Say Do checklist to report near misses, hazards, unsafe conditions, and unsafe behaviors. Capture work activity, location, reporter details, and classify the report as improvement, hazard, near miss, OFI, or NCR. Document observations, possible consequences, and suggested actions, then assign owners and due dates to drive corrective actions. Includes fields for Golden Rule breach checks and database entry to support continuous safety improvement.

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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 .

Template
Near Miss Report Template
This Near Miss Report template helps construction teams quickly capture and investigate near-miss events before they cause harm. Record key details such as document number, client or site, date and time, location, personnel, and department. Identify factors including unsafe acts, unsafe conditions, unsafe equipment, or improper equipment use. Describe the incident or hazard, attach photos, and capture employee signatures and dates. The investigation section guides users to document the near-miss condition, identify primary and contributing causes, and define corrective actions such as removing hazards, replacing or repairing equipment, or retraining staff. Includes management sign-off to close the loop and improve site safety and HSE compliance.
by Chris Graydon, from the Community
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Near Miss and Hazard Spot Report
Capture and document near misses and hazard observations with this easy-to-use report template. Record key details such as project name and number, date, location, description of the event, and actions taken. Attach media to support the report, assign follow-up tasks, and note who completed the action to close the loop. Designed to standardize incident and hazard reporting across worksites, this template helps teams improve safety awareness, track corrective actions, and prevent future incidents. Suitable for a wide range of workplaces and job sites.
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Safety Incident Report Template
Use this Safety Incident Report template to document near misses, unsafe acts, unsafe conditions, and positive safety behaviors. Capture key details such as location, date, reporter, situation type, and location type including manufacturing, warehouse, office, lab, and offsite. Record root causes across environment and housekeeping, machinery and equipment, materials, procedures and instructions, employee actions, and ergonomics. Add incident descriptions, photos, and suggested corrective actions to drive remediation and prevention. Ideal for daily operations and audits where consistent incident documentation and follow up are essential.
by Production FXUK, from the Community
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ABB RIC Near Miss And Hazard Report
Use this template to report all Near Misses, Hazardous Conditions and Unsafe Acts in the Richmond, VA facilities.
by Marco Guarniere, from the Community
Downloads: 80+
Get

Near Miss Report Template

This Near Miss Report template helps construction teams quickly capture and investigate near-miss events before they cause harm. Record key details such as document number, client or site, date and time, location, personnel, and department. Identify factors including unsafe acts, unsafe conditions, unsafe equipment, or improper equipment use. Describe the incident or hazard, attach photos, and capture employee signatures and dates. The investigation section guides users to document the near-miss condition, identify primary and contributing causes, and define corrective actions such as removing hazards, replacing or repairing equipment, or retraining staff. Includes management sign-off to close the loop and improve site safety and HSE compliance.

by Chris Graydon, from the Community

Get

Template

Near Miss and Hazard Spot Report

Capture and document near misses and hazard observations with this easy-to-use report template. Record key details such as project name and number, date, location, description of the event, and actions taken. Attach media to support the report, assign follow-up tasks, and note who completed the action to close the loop. Designed to standardize incident and hazard reporting across worksites, this template helps teams improve safety awareness, track corrective actions, and prevent future incidents. Suitable for a wide range of workplaces and job sites.

by Ian Martin, from the Community

10+

Get

Template

Safety Incident Report Template

Use this Safety Incident Report template to document near misses, unsafe acts, unsafe conditions, and positive safety behaviors. Capture key details such as location, date, reporter, situation type, and location type including manufacturing, warehouse, office, lab, and offsite. Record root causes across environment and housekeeping, machinery and equipment, materials, procedures and instructions, employee actions, and ergonomics. Add incident descriptions, photos, and suggested corrective actions to drive remediation and prevention. Ideal for daily operations and audits where consistent incident documentation and follow up are essential.

by Production FXUK, from the Community

10+

Get

Template

ABB RIC Near Miss And Hazard Report

Use this template to report all Near Misses, Hazardous Conditions and Unsafe Acts in the Richmond, VA facilities.

by Marco Guarniere, from the Community

80+

Get

MCDGRPNZ See Say Do Hazard Report

About author

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Near Miss Report Template

Near Miss and Hazard Spot Report

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Near Miss Report Template

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