Near-miss report
Records near misses and related incidents, the immediate response, investigation, notifications, corrective actions, evidence and authorised close-out. A live form your crew fills on their phones, not a Word template you retype on every site.
- Near misses
- Related incidents
- The immediate response
- Investigation
- Notifications
- Corrective actions
This form ships inside 2 form packs. Pick the pack built for your setting and it arrives live in your Eaco workspace, branded to your business.
Not sure which pack? Tender-Ready Compliance Forms Pack for Commercial Cleaners is the fastest way in.
Rendered from the live form itself. Your logo replaces the placeholder the day you buy. On Eaco, branding is included, not a paid extra.
When you need this form
The wet floor nobody slipped on. The ladder that shifted. The chemical decanted into an unlabelled bottle and caught before use. Near misses are free lessons, and a safety management system lives or dies on whether they are captured. Client safety audits routinely sample near-miss records, because a company reporting none is usually not looking rather than genuinely incident-free.
Auditors follow the thread from report to close-out. A live form keeps that thread intact: who reported it, what was done immediately, what the investigation found, who was notified, which control changed and who verified it worked. A paper form that stops at the description proves the event happened and nothing more. Tender panels notice the difference.
What good looks like
- The sequence of events described factually, without blame or guesswork.
- Immediate response recorded: area isolated, task stopped, equipment tagged out.
- Contributing factors identified, separating the trigger from the underlying cause.
- Notifications logged: supervisor, client contact, health and safety representative.
- Corrective action verified as effective, then closed out by an authorised person.
Included in 2 form packs
Compare all packsEvery pack below carries the Near-miss report plus the forms that win work in its setting. Buy the pack once and every form in it goes live, branded to you.
Near-miss report, answered
Is this a PDF or Word template?
Neither. It is a live form: your crew opens it on their phones, ticks it through, attaches photos and signs on the glass. Every submission is timestamped, GPS-pinned and stored as proof.
Do near misses need to be reported?
Under most safety management systems, yes. Even where nobody was hurt, the record shows the hazard was identified and controlled. Clients and auditors treat a healthy near-miss log as a sign of a working system.
What is the difference between a near miss and an incident?
An incident caused harm or damage. A near miss had the same potential but stopped short. Both need investigating, because the difference between them is usually luck, not control.
Can I buy just this one form?
Forms ship in packs, from $99 one-time with GST included. Or get every form, this one and 276 more, plus Eaco AI on the $29 a month plan.