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Near miss report

Form · Each near miss

Records something that could have hurt someone but didn't, so it can be put right before it does.

Use it in Sitro: add it to a project and fill it on a phone, free for 14 days.

The law and guidance behind it

  • Management of Health and Safety at Work Regulations 1999, Regulation 5 (arrangements, monitoring and review)

The questions

The near miss

  1. Date
  2. Where on site
  3. What happened
  4. What could have happened
  5. Photos

Action

  1. Action taken
  2. Reported by

A template to adapt to your site, not legal advice.

More health and safety templates

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