Jocelyn Ruston

JR Good Catch/Near Miss Report

Safety

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Use this Template

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Information

Document No.
Audit Title
Client / Site Name
Conducted on
Prepared by
Location
Personnel

Good Catch or Near Miss :
Nature of Incident (i.e. fall, struck by, caught between, slip/trip) :<br><br>
What happened ? ( please explain with detail ):
How / Why did this incident happen :
Severity of incident ( 10 major - 1 minor )
What is being done to prevent recurrence ?
Is the crew aware of changes to prevent recurrence?
Date and time of incident
Signature of Filer

Jocelyn Ruston

JR Good Catch/Near Miss Report

Safety

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.