Printable Near-Miss Report Template
This one-page near-miss report is for workplaces, job sites, schools, and any team that wants a clear record of close calls before they become incidents. It includes fields for date, time, location, reported by, what could have happened, what caused it, and a suggested fix.
Free printable · PDF
- 2 pages
- US Letter — choose “Fit to page” for A4
- PDF, 51 KB
Free for personal, family and classroom use.
Fill it out right after the event while details are fresh. Use it to track patterns, share the report with safety staff or supervisors, and keep a consistent record of hazards, causes, and actions taken.
Good for
- Record workplace close calls
- Track hazard patterns
- Document suggested fixes
Tip: Print extra copies and keep one near shared work areas for quick reporting.
6 files · DOCX, PDF, XLSX
Get every sheet: Incident Report Template Pack
This sheet plus 5 more in one download, with the editable Word and Excel files. Editable incident report, near-miss report, witness statement and root-cause investigation forms, plus an Excel corrective action log and incident register.
$7.00 USD, one-time 6 files · about $1.17 each
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Printable Incident Report Form
Printable Witness Statement Form
Incident Investigation Form
Corrective Action Log Template
Printable Incident Register Template