Template

Good Catch, Near Miss and Incident First Report

by Glenn Sizemore, CHST, STS, from the Community

Use this in-house first report form to document good catches, near misses, and incidents in utility field operations. Capture event details, involved crew and foreman, evidence photos, repairs, and prevention steps. Log utility notifications, contractor oversight contacts, and screening or police report requirements to speed investigation and corrective action.

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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.

Template
Good Catch and Near Miss Incident First Report
This incident first report template helps wireless and telecom field crews capture Good Catches, Near Misses, Injuries, Thefts, Property Damage, Vehicle Accidents, Utility Strikes, and significant safety violations. Record crew members and foreman, event details, required notifications, and whether police reports or screenings were completed. Attach photos of incidents and repairs, note corrective actions, and document how the event could have been prevented. Designed to reduce confusion during investigations and standardize reporting across teams.
by Glenn Sizemore, CHST, STS, from the Community
Downloads: 0
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Template
Near-Miss/Incident Form
Form for reporting near misses or incidents on site
by Mark Taylor, from the Community
Downloads: 60+
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Template
JR Good Catch and Near Miss Report
Use this Good Catch and Near Miss Report template to record potential incidents and hazards before they cause harm. Capture what happened, why it happened, the nature of the incident, and a severity rating from 1 to 10. Document corrective actions, crew awareness of changes, and steps to prevent recurrence. Include location, personnel, date and time, and a filer signature to create a complete, auditable safety record for the job site.
by Jocelyn Ruston, from the Community
Downloads: 0
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Template
Good Catch and Near Miss Report Form
This CVG template helps teams report good catches near misses and safety suggestions in warehouse and logistics operations. Capture concerns related to dock doors pallets racking PPE and housekeeping and log exact locations by aisle bay level and position. Document findings source and root cause then add proposed resolutions and note if the issue is resolved. Track specific equipment and dock door numbers and identify zones such as admin battery charging outbound or inbound areas. Use this form to standardize reporting improve hazard visibility and prevent incidents across shifts.
by Chance Schuh, from the Community
Downloads: 10+
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Good Catch and Near Miss Incident First Report

This incident first report template helps wireless and telecom field crews capture Good Catches, Near Misses, Injuries, Thefts, Property Damage, Vehicle Accidents, Utility Strikes, and significant safety violations. Record crew members and foreman, event details, required notifications, and whether police reports or screenings were completed. Attach photos of incidents and repairs, note corrective actions, and document how the event could have been prevented. Designed to reduce confusion during investigations and standardize reporting across teams.

by Glenn Sizemore, CHST, STS, from the Community

Get

Template

Near-Miss/Incident Form

Form for reporting near misses or incidents on site

by Mark Taylor, from the Community

60+

Get

Template

JR Good Catch and Near Miss Report

Use this Good Catch and Near Miss Report template to record potential incidents and hazards before they cause harm. Capture what happened, why it happened, the nature of the incident, and a severity rating from 1 to 10. Document corrective actions, crew awareness of changes, and steps to prevent recurrence. Include location, personnel, date and time, and a filer signature to create a complete, auditable safety record for the job site.

by Jocelyn Ruston, from the Community

Get

Template

Good Catch and Near Miss Report Form

This CVG template helps teams report good catches near misses and safety suggestions in warehouse and logistics operations. Capture concerns related to dock doors pallets racking PPE and housekeeping and log exact locations by aisle bay level and position. Document findings source and root cause then add proposed resolutions and note if the issue is resolved. Track specific equipment and dock door numbers and identify zones such as admin battery charging outbound or inbound areas. Use this form to standardize reporting improve hazard visibility and prevent incidents across shifts.

by Chance Schuh, from the Community

10+

Get

Good Catch, Near Miss and Incident First Report

About author

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Good Catch and Near Miss Incident First Report

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Good Catch and Near Miss Incident First Report

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