Anonymous

HF Near Miss Report

Identification of hazards, risk assessment and risk control

Use this Template

Print as PDF

Use this Template

Go digital today!

Convert your paper checklists into digital forms

Scan this QR code to use this paper checklist on your smartphone or tablet or visit https://safetyculture.com/

Title Page

Title
Reported by
Reported to
Worksite Supervisor
Workers on location
- Thomas
- Fillipe
Conducted on
Location

Near Miss Report
NEAR MISS (Add description of near miss and control if implemented)
Reported by and signature

Anonymous

HF Near Miss Report

Identification of hazards, risk assessment and risk control

Use this Template

Print as PDF

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.