Near-miss report

When you need this form

The wet floor nobody slipped on. The ladder that shifted. The chemical decanted into an unlabelled bottle and caught before use. Near misses are free lessons, and a safety management system lives or dies on whether they are captured. Client safety audits routinely sample near-miss records, because a company reporting none is usually not looking rather than genuinely incident-free.

Auditors follow the thread from report to close-out. A live form keeps that thread intact: who reported it, what was done immediately, what the investigation found, who was notified, which control changed and who verified it worked. A paper form that stops at the description proves the event happened and nothing more. Tender panels notice the difference.

What good looks like

• The sequence of events described factually, without blame or guesswork.
• Immediate response recorded: area isolated, task stopped, equipment tagged out.
• Contributing factors identified, separating the trigger from the underlying cause.
• Notifications logged: supervisor, client contact, health and safety representative.
• Corrective action verified as effective, then closed out by an authorised person.