Skip to content
SafetyCulture
Template

Quick Near Miss Form

by SafetyCulture

Free
295

Use this near miss form to quickly record the incident and indicate of work stopped or continued business as usual.

About author

Free 1,000+ Workplace Checklists & Templates created by the SafetyCulture team.

You might also like

  • Near Miss Report Form
    SafetyCulture logo
    Template

    Near Miss Report Form

    A near miss is an unplanned event that threatens human safety or health, the environment, or the continued normal operation of the business enterprise, wherein the last protective barrier is challenged, but defeated. Use this near miss form to report a near miss incident.

    by SafetyCulture
    2375 downloads
    Get
  • Near Miss Template
    SafetyCulture logo
    Template

    Near Miss Template

    This near miss template allows providing the description and photos surrounding the incident as well as inclusion of the names of other witnesses of the near miss.

    by SafetyCulture
    246 downloads
    Get
  • Near Miss Notification Form
    SafetyCulture logo
    Template

    Near Miss Notification Form

    Fill out this form to report a Near Miss. Once complete be sure to hit the COMPLETE button and email the form to your direct manager or the Health & Safety Manager.

    by SafetyCulture
    285 downloads
    Get
  • OSHA Near Miss Form
    SafetyCulture logo
    Template

    OSHA Near Miss Form

    Based on the Incident Investigation Form provided by OSHA in their Incident Investigation Guide for Employers, this digital near miss form can be used to do the following: 1) Preserve or document the scene, 2) Collect information, 3) Determine root causes, 4) Implement corrective actions.

    by SafetyCulture
    100 downloads
    Get