Title Page

  • Near Miss

  • Brief Description

  • Site

  • Recorded by

  • Rate Potential of Harm

  • Rate likelihood of re-occurrence

Date & time:

  • Select date

  • Where did it happen

  • Details of Indecent

  • Photographic evidence (if applicable):

Person Reporting

  • Supervisor IMannformed

  • Are you a Graham Roofing Employee

  • Name

Managers responce

  • What have you done to prevent

  • Manager

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.