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SafetyCulture
Template

DRS Near Miss Notification Form

by Chris Reynolds, from the Community

Downloads: 2,000+
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Use this near miss notification form to quickly capture and report workplace safety near miss events. Record date and time, location or customer site, company cell and vehicle number, a clear description of what happened, contributing factors, and what was learned or changed. Attach photos for clarity and sign to confirm accuracy, then email the completed form to the Health and Safety Manager or Claims Manager for 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

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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.