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Near Miss Incident Report Form
Life Safety, Maintenance, Service
The Near Miss Incident Report Form is used to document events that could have resulted in injury, damage, or loss but were narrowly avoided. It helps organizations identify potential hazards before they cause harm. This is a mobile Near Miss Incident Report Form compatible with iOS and Android mobile devices and tablets.
*Please complete the qualifying fields on the next page to get full access to a copy of this form. Use this form on your mobile phone, tablet or download as PDF.

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The Near Miss Incident Report Form enables organizations to capture and analyze incidents that did not result in injury or property damage but had the potential to do so. Reporting near misses provides valuable insights into unsafe conditions and behaviors, allowing teams to take corrective actions before a serious event occurs. Used widely in industries like construction, oil and gas, and manufacturing, the Near Miss Incident Report Form is an essential part of a proactive safety culture. It encourages workers to report hazards without fear of blame, fostering open communication and continuous improvement in safety practices. Digital versions make it simple to log incidents instantly and share them with safety managers for follow-up.

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