Information

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Near Miss
    Definition: An event that had a high likelihood of resulting in an injury, equipment, environmental, or property incident but did not.

    This information will be used as a preventative measure for possible future incidents.

  • Description of event:

  • Suggestions for corrective action:

  • Witness(es):

  • Type of incident:

  • Risk Potential:

  • Severity:

  • Probability:

  • Add a picture:

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.