A Near Miss Reporting Form will help you to report a near miss and take photos for better reporting.
Use this form for near misses to quickly record the incident and allow you to stop or continue working.Download template
Fill out this form to report a near miss. Once completed, send it to your direct supervisor.Download template
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Using a near miss reporting form will help you to describe and document an unplanned event that occurs suddenly and has the potential to cause injury or damage. These incidents are not uncommon in most workplaces. For example, if a construction worker slips on a scaffold but does not fall, it is important to report the incident. Important details about the near-accident are recorded in a form. Such a near miss report, sometimes also called near accident or critical incident aims to reduce risks and in the best case to avoid them in the future.
Often little near miss events are played down and not reported to the superiors, according to the motto: "Nothing happened" - but this should not happen. Only if the near accident event is reported can the sources of danger be recognized early and quickly eliminated. In addition to the superior, the contact persons in the company are the occupational safety specialist, the safety officer or the works or staff council.
It helps the employees if a form exists in the company for the immediate reporting of the near accident. This near miss form contains all the important facts about the incident. The detailed information enables hazards to be eliminated quickly.
A good near miss report should be easy to understand, comprehensive and contain the following basic details:
The reporting of near misses is essential in every industry, especially in those where there is a very high risk of accidents to workers. It raises companies' awareness of the threats, hazards and risks that an employee is exposed to and should deal with.
An employee used a ladder to climb onto the roof and repair a leak. On reaching the fourth step, he slips with his foot but manages to regain his balance. There was no accident.
After the submission of a near miss report, the ladder was inspected, and it was found that a step profile was missing. This was immediately repaired so that other employees could not be involved in a similar accident or near miss accident.
One of the most important factors in the successful introduction and implementation of near miss report forms is to make reporting events as simple and straightforward as possible by paying attention to the following:
A near miss can occur daily in all industries but is not always reported and sometimes considered too unimportant. Besides, paper-based near miss forms take a lot of time to fill in, and the reports submitted are often lost. Pen and paper are therefore not the ideal solutions for a successful error culture.
With Lumiform's mobile app, any near miss is easily performed using a tablet or smartphone - online or offline. The desktop software is used to create a standardized near miss form for the company. The data collected from the reported near misses can also be evaluated here. The use of the mobile solution significantly reduces the risk of quality losses, occupational accidents and documentation errors.
The risks discovered are often time-critical. This makes it all the more important to take appropriate action immediately to prevent such incidents from happening again and causing serious problems. Digitizing near miss reports with Lumiform offers numerous advantages:
The following easy-to-use, digital form templates for a near miss simplify and speed up the reporting process. They can be downloaded and used anytime, anywhere with the Lumiform mobile app for free.