Template

Hazard or Near Miss Report

by Paul Harron, from the Community

10+

Use this Hazard or Near Miss Report template to document hazards and near misses quickly and consistently. Capture date, location, job reference, photos, whether work was paused, immediate containments, risk details, and corrective actions. Standardize reporting to improve safety visibility and prevent incidents across your site. Adapt this checklist to your operation and share submissions with supervisors for fast follow-up.

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.

Template
Near Miss and Safety Share Checklist
Use this near miss and safety share template to document incidents and lessons learned across fleet operations. Capture job details, people involved, date and time, location, near-miss type (unsafe act, condition, or equipment), narrative of what happened, supporting photos, and recommendations. Assign corrective actions and a responsible party, record general observations, and share safety insights to prevent future incidents.
by Casey Blackford, from the Community
Downloads: 10+
Get
Template
Baileys Hazard Spotting and Near Miss Reporting Form
This hazard spotting and near miss reporting form helps teams quickly capture unsafe conditions or incidents, suggest corrective actions, and document manager follow up to ensure timely resolution. Sections include site and date, reporter details, description of the hazard or near miss, recommended actions, and confirmation that the issue has been resolved with manager name, signature, and dates. Use this template to standardize reporting, improve communication, and reduce risk across projects and worksites.
by jon Hillyard, from the Community
Downloads: 0
Get
Template
Near Miss Reporting Template
Use this Near Miss Reporting template to document potential hazards and incidents that did not result in injury. Capture audit details, site, department, date and time, who was involved, and whether it involved an unsafe act, condition, or equipment. Describe the near-miss, outline primary and contributing causes, and record corrective actions such as removing hazards, repairing or replacing equipment, or retraining staff. Include management sign-off to close the loop. Standardize near-miss investigations to reduce risk, strengthen safety culture, and prevent future incidents across operations.
by Danny White, from the Community
Downloads: 10+
Get
Template
Near-Miss/Incident Form
Form for reporting near misses or incidents on site
by Mark Taylor, from the Community
Downloads: 70+
Get

Near Miss and Safety Share Checklist

Use this near miss and safety share template to document incidents and lessons learned across fleet operations. Capture job details, people involved, date and time, location, near-miss type (unsafe act, condition, or equipment), narrative of what happened, supporting photos, and recommendations. Assign corrective actions and a responsible party, record general observations, and share safety insights to prevent future incidents.

by Casey Blackford, from the Community

10+

Get

Template

Baileys Hazard Spotting and Near Miss Reporting Form

This hazard spotting and near miss reporting form helps teams quickly capture unsafe conditions or incidents, suggest corrective actions, and document manager follow up to ensure timely resolution. Sections include site and date, reporter details, description of the hazard or near miss, recommended actions, and confirmation that the issue has been resolved with manager name, signature, and dates. Use this template to standardize reporting, improve communication, and reduce risk across projects and worksites.

by jon Hillyard, from the Community

Get

Template

Near Miss Reporting Template

Use this Near Miss Reporting template to document potential hazards and incidents that did not result in injury. Capture audit details, site, department, date and time, who was involved, and whether it involved an unsafe act, condition, or equipment. Describe the near-miss, outline primary and contributing causes, and record corrective actions such as removing hazards, repairing or replacing equipment, or retraining staff. Include management sign-off to close the loop. Standardize near-miss investigations to reduce risk, strengthen safety culture, and prevent future incidents across operations.

by Danny White, from the Community

10+

Get

Template

Near-Miss/Incident Form

Form for reporting near misses or incidents on site

by Mark Taylor, from the Community

70+

Get

Hazard or Near Miss Report

About author

You might also like

Near Miss and Safety Share Checklist

Baileys Hazard Spotting and Near Miss Reporting Form

Near Miss Reporting Template

Near-Miss/Incident Form

You might also like

Near Miss and Safety Share Checklist

Baileys Hazard Spotting and Near Miss Reporting Form

Near Miss Reporting Template

Near-Miss/Incident Form