Near Miss Report Form


Use this form to report near misses.

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Full Description

When safety incidents almost occur on a construction site, reporting them can be useful. By identifying “near misses” you can than understand trends, and work to prevent incidents before they happen.

This near miss report form allows employees to document and report them formally, you can track:

  • date and time of near miss
  • who it occured to
  • location of the near miss
  • details of the near miss

This form is a pdf form and features fillable fields.


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Screenshot 2022 06 04 123037 - Near Miss Report Form
Near Miss Report Form