Every serious workplace accident is preceded by dozens of near-misses that went unreported. The Incident & Near-Miss Report template gives your safety team a structured, easy-to-use document that captures both actual incidents and near-misses before they become injuries — with a focus on root cause investigation and corrective action that prevents recurrence.

Built for operations teams that take safety seriously, this template supports a proactive safety culture where reporting a near-miss is valued, not punished.

What's Included:

• Incident / near-miss classification: actual injury, property damage, near-miss, or unsafe condition
• Severity rating scale with potential consequence assessment
• Event description section with time, location, and involved parties
• Immediate response: first aid, containment, and area isolation actions
• Root cause investigation: using 5-Why or contributing factor analysis
• Corrective and preventive action plan with owner, due date, and effectiveness check

Who It's For:

Operations managers, EHS (Environmental Health & Safety) teams, warehouse supervisors, and any department managing physical operations where safety incidents and near-misses occur.

Why It Matters:

Organizations that systematically capture and investigate near-misses have dramatically lower serious injury rates. This template makes reporting fast and structured — reducing the friction that prevents people from speaking up about what they almost saw happen.

Format: Microsoft Word (.docx) — structured, professional, and editable. Use digitally or print as a floor-accessible reporting form. Download and build a reporting culture that prevents the next incident.