Free template

Free near miss report template.

Report near misses so they don’t become incidents.

Report near misses so they don’t become incidents.

When to use it

Whenever something nearly went wrong.

The checklist

Details

  • What happened.

  • Where and when.

  • Photo of the hazard.

Action

  • Immediate fix.

  • Longer-term fix as a task.

Use this template in Please Do It

Create a task for each report. Add these steps as a checklist and ask for a photo when it’s done. The owner gets it automatically, and you see it’s finished without asking.

Frequently asked questions

Should near misses be anonymous?

Allowing anonymity can increase reporting. Focus on fixing hazards, not blame.

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