Near miss format 2026

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The document is an Accident/Incident/Near Miss Report Form designed to collect detailed information about workplace accidents or near misses. It includes sections for identifying the injured person, describing the incident, detailing injuries and damages, emergency measures taken, witness information, equipment involved, working conditions, safety procedures followed, and personal protective equipment (PPE) worn. Additionally, it prompts for recommendations to mitigate risks and requires signatures for initial investigations. The form must be submitted to a designated email or postal address.

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Click ‘Get Form’ to open the near miss format in the editor.
Begin by entering the name of the injured person(s) and the date of the incident. This information is crucial for record-keeping.
Select the type of incident from options such as 'Near Miss', 'Accident', or 'Ill Health'. This categorization helps in analyzing trends.
In the details section, answer questions about what the injured person was doing at the time, how the injury occurred, and describe any injuries or damages.
Document any emergency measures taken and list witnesses' names to provide a comprehensive account of the incident.
Fill in details about equipment involved, working conditions, and whether safe working procedures were followed.
Indicate what personal protective equipment (PPE) was worn during the incident and confirm understanding of safety instructions by all parties involved.
Finally, provide recommendations for reducing risks and complete your contact information before submitting your form.

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Versions	Form popularity	Fillable & printable
2017	4.9 Satisfied (48 Votes)

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How do you write a near miss?

In general, here is the information you should include in a near-miss report: Date, time, and location of the incident. Department. Incident description. Root cause (behavior, equipment, etc.) Supporting documents (photos, hazard analyses, etc.) Next steps and specific action items.

What does OSHA consider a near miss?

After years of near misses, the team has finally won a championship. Sounds like a long way, but in space, thats a near miss. There are still lessons to be drawn from his win and his near miss.

How does OSHA define a near miss?

Merriam-Webster, oddly enough, does not use a hyphen in near miss. So, I used global search and replace to change back to near miss.

What is a good near miss example?

During roof work, a worker nearly steps backwards off the edge but is called out by a coworker just in time. A tool is dropped from a height but doesnt hit anyone. On a construction site, a temporary guardrail is dislodged but noticed and fixed before anyone leans against it and potentially falls.