Near Miss/Hazard Report - Real Life Choices

Near Miss Hazard Report

Step 1 of 2

Use this form when a near miss/hazard occurs that could have caused an injury or an incident.
Your details
Your name*
Position
Date of near miss/hazard
Date Format: MM slash DD slash YYYY
Time of near miss/ hazard

: HH

MM
Location of near miss/ hazard
Location address of near miss/ hazard
Name of any witnesses (if any)

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