Near Miss Report Form
Capture the event, potential severity, causes, immediate actions, and investigation ownership before harm occurs.
HSE managers and site supervisors use this check across construction sites, plants, camps, hotels and workshops. It walks through What nearly happened, Potential consequences, Causes and Immediate actions & investigation.
Site teams in Ghana, Nigeria and similar markets use it when the inspection is still a clipboard, a WhatsApp photo or an Excel sheet rebuilt after the shift.
This PDF is a sample for inspections done by hand. AuditDAT does not work with paper checklists. We digitise the form. Your team then does the check on a phone or tablet, even with no signal. Photos, notes and a signature stay on the inspection. A fail becomes a job card before you leave site. Learn more
The rest of this checklist is locked. Enter your work email to download the PDF.
On the form
What this inspection covers
Capture near misses before they become incidents.
- 01
What nearly happened
- 02
Potential consequences
- 03
Causes
- 04
Immediate actions & investigation
When a line fails
Each line is marked pass, fail, or not applicable. In AuditDAT, a fail becomes a job card with an owner and a due date before you leave the site.
FAQ
What does this Near miss report check cover?
What does this Near miss report check cover?
It covers What nearly happened, Potential consequences, Causes and Immediate actions & investigation. HSE managers and site supervisors use it across construction sites, plants, camps, hotels and workshops. The PDF is a sample for teams still inspecting by hand. AuditDAT does not use paper checklists. The check runs on a phone, and a fail becomes a job card.
Does AuditDAT use this Near miss report checklist on paper?
No. The PDF is a sample for teams still doing inspections by hand. AuditDAT does not work with paper checklists. We digitise the form. Your team then inspects on a phone, tablet or the web, even with no internet. A fail becomes a job card with an owner and a due date.
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