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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.
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Use this incident investigation template to help conduct a root cause analysis following an incident or near miss at a worksite or workplace. This template can be used to help gather necessary facts and general background information of the incident.
Use this near miss form to quickly record the incident and indicate of work stopped or continued business as usual.
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.
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.
