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FormSafety & Workshop

Incident & near-miss form

Record what happened and any follow-up needed after an incident or near miss.

Form

Record

  • Date, time, and work area
  • People involved or witnesses
  • What happened
  • Immediate action taken
  • Equipment or materials involved

Form

Follow-up

  • What should change
  • Who is responsible for follow-up
  • Target completion date
  • When the follow-up was closed