Get the free Near miss incident injury notification form

Near miss / incident / injury notification form Version 5 December 2014 This notification must be completed and emailed to safety ragga.NSW.gov.AU or faxed to 02 6926 9289 within one (1) working day

How to fill out near miss incident injury

How to fill out a near miss incident injury:

1. Gather all relevant information: Before starting to fill out the near miss incident injury form, gather all the necessary information related to the incident. This may include the date, time, location, individuals involved, witnesses, and any other details that might be relevant to the incident.
2. Describe the incident: Begin by providing a detailed description of the near miss incident. Include information about what happened, how it happened, and any contributing factors that may have led to the incident. Be as specific as possible to ensure a thorough understanding of the situation.
3. Identify potential hazards: In this section, list any potential hazards or unsafe conditions that may have contributed to the near miss incident. This could include unsafe equipment, inadequate training, lack of proper safety protocols, or any other factors that could have posed a risk to individuals involved.
4. Document actions taken: Describe any actions that were taken to address the near miss incident. This may include immediate actions taken to mitigate the risk, such as removing individuals from the area, notifying supervisors, or administering first aid if necessary. Additionally, outline any corrective actions that were implemented to prevent similar incidents in the future.
5. Provide recommendations: Use this section to offer recommendations for preventing similar near miss incidents and improving overall safety in the future. These recommendations may involve additional training, implementing new safety protocols or procedures, conducting regular inspections, or any other measures that could help mitigate risks.

Who needs near miss incident injury?

1. Employers: Employers, particularly those in high-risk industries, need to be aware of near miss incidents and injuries. It is their responsibility to ensure a safe working environment for their employees and take necessary actions to prevent near misses from becoming actual incidents.
2. Employees: Employees who witness or are involved in near miss incidents should report them promptly. By doing so, they contribute to a safer workplace and prevention of potential injuries or accidents.
3. Safety professionals: Safety professionals play a crucial role in analyzing near miss incidents and injuries. They use this information to identify patterns, determine root causes, and develop strategies to enhance workplace safety.

In summary, filling out a near miss incident injury form involves providing a detailed description of the incident, identifying hazards, documenting actions taken, and offering recommendations. Employers, employees, and safety professionals all need to be aware of near miss incidents and injuries in order to maintain a safe working environment.

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What is near miss incident injury?

Near miss incident injury is an event that could have resulted in an injury or illness, but did not.

Who is required to file near miss incident injury?

All employees are required to report a near miss incident injury to their supervisor or safety officer.

How to fill out near miss incident injury?

You can fill out a near miss incident injury report by providing details of the incident, including date, time, location, and a description of what happened.

What is the purpose of near miss incident injury?

The purpose of reporting near miss incident injuries is to identify potential hazards and prevent future incidents from occurring.

What information must be reported on near miss incident injury?

Information such as the date, time, location, description of the incident, and any contributing factors must be reported on a near miss incident injury report.