Incident Close Call Reporting Form 2026

1. Click ‘Get Form’ to open the Incident Close Call Reporting Form in the editor.
2. Begin by entering the 'Date of incident', 'Company', and 'Location' in the designated fields. This information is crucial for tracking and reporting purposes.
3. Fill in your name under 'Reported by' and select the 'Type of job' related to the incident. This helps categorize the report accurately.
4. In the 'Describe incident / close call' section, provide a detailed account of what occurred. If necessary, utilize the space provided for diagrams on the reverse side.
5. Select applicable categories such as 'close call', 'bodily injury/illness', or others, and add any relevant notes to clarify your selections.
6. Document names and contact information of witnesses involved in the incident for follow-up purposes.
7. Describe both immediate and root causes of the incident using checkboxes and notes to ensure comprehensive analysis.
8. Outline corrective actions that will be taken, along with responsible persons and deadlines for completion.
9. Finally, ensure all required signatures are obtained before sending a copy of this report to your supervisor.

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