Template

Circus Oz Incident or Near Miss Report

by Regina Hill, from the Community

Use this Circus Oz Incident or Near Miss Report template to document workplace incidents and near misses thoroughly. Capture event date and time, location, risk priority, activity, and incident type. Log evidence, vehicles, equipment, damages, and other items with photos. Record people involved, statements, injuries and affected body parts, causes, and immediate medical attention. Assign and track corrective actions, then finalize with reporter sign-off. This Public Library template is an example to help you get started and does not constitute professional advice; assess suitability for your workplace or jurisdiction.

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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
Incident Report Template: First Response
Use this first response incident report template to quickly capture facts after an incident, accident, or near miss. Document incident type and priority, location, weather, and medical attention. Log evidence, vehicles, equipment, damages, and other items with photos and IDs. Record people involved, witness statements, injuries, affected body parts, and causes. Add corrective actions and assign follow-ups to support timely, compliant investigations across transport operations and other workplaces.
by James Farrand, from the Community
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Incident Report Detailed
Use this detailed incident report template to document workplace incidents on construction sites and other environments. Record incident type and priority, date and location, weather conditions, and loss time. Log evidence, equipment and vehicle details, damages, and other items. Document people involved, statements, injuries and affected body parts, and medical attention provided. Add corrective actions, assign follow-ups, and complete sign-off to support compliance, investigations, and continuous safety improvement.
by Greg McGee, from the Community
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Template
Incident Report First Response Checklist
Use this Incident Report First Response template to quickly document workplace incidents and near-misses. Capture incident type, priority, location, time, weather and environmental conditions, and whether medical attention is required. Log evidence with photos, plus vehicle, equipment, damage, and other item details. Record all people involved, injuries sustained, affected body parts, and likely causes. Add corrective actions, note follow-up requirements, and complete sign-off for a thorough, compliant investigation trail.
by Quantum Leap Safety Limited, from the Community
Downloads: 10+
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Template
Motor Mall Incident Report - First Response V2.0
Use this incident report template to capture first response details after an incident, accident, near miss or injury at an automotive dealership or transport site. Record date, time, location, incident type and priority, describe what happened, and note weather conditions. Log evidence with photos, vehicle, equipment and damage details. Document all people involved, statements and injuries, including body parts affected and causes. Add corrective actions, assign follow ups and complete sign off to support a thorough investigation.
by Liam Daniels, from the Community
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Circus Oz Incident or Near Miss Report

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