Template

Good Catch and Near Miss Incident First Report

by Glenn Sizemore, CHST, STS, from the Community

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.

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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, Near Miss and Incident First Report
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.
by Glenn Sizemore, CHST, STS, from the Community
Downloads: 10+
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Template
Accident Incident Near Miss Report Template
Use this incident report template to document accidents, incidents, and near misses on site. Capture personal and witness details, incident type and category, location, task, equipment, and PPE in use. Record a clear description of the event, photos, causal factors, and immediate corrective actions. Log injuries, first aid, emergency response, and return to work information, and note if the event is reportable under RIDDOR. Attach supporting evidence such as inductions, permits, RAMS, training and inspection records, and witness statements.
by Colin Johnstone, from the Community
Downloads: 20+
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Template
Incident and Near Miss Report
Use this Incident and Near Miss Report template to capture key details about accidents and near misses on site. Log the date, time, job, location, description of the event, injuries, property or equipment damage, and photos. Identify likely causes, add annotations of the surrounding environment, and record corrective actions to stop recurrence. Include signatures for preparer and site manager or supervisor once actions are implemented and monitored. Designed for workplace safety programs, especially on construction sites, this template supports consistent reporting and investigation to improve safety outcomes.
by Jeff Pratt, from the Community
Downloads: 0
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Template
Good Catch and Near Miss Report
Use this Good Catch and Near Miss Report template to capture and communicate safety observations before they become incidents. Record site information, project name, location, date, and preparer. Describe the event, identify contributing factors, and outline discussion points with the team. Define corrective actions, assign responsibility, and specify how actions will be implemented to remove hazards and prevent recurrence. This practical template helps standardize reporting, support safety culture, and drive continuous improvement on projects and jobsites.
by Ryan Hacke, from the Community
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Good Catch and Near Miss Incident First Report

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