Get the free Safety Suggestion Near Miss Reporting Form - northcountyfire

FD79 (6×18/2013) Safety Suggestion / Near Miss Reporting Form. Please use this form to provide safety suggestions, report suspected unsafe conditions,

How to fill out safety suggestion near miss

How to fill out a safety suggestion near miss:

1. Begin by providing your contact information, including your name, job title, and contact number. This will allow the relevant authorities to reach out to you if they need further clarification or information.
2. Describe the near miss incident in detail. Include information such as the date, time, and location of the incident. Be specific about what happened and how it occurred. This will help others understand the situation better and identify potential hazards.
3. Analyze the root cause of the near miss incident. Try to identify why it happened and what factors contributed to it. This analysis will help in developing effective preventive measures.
4. Provide any additional information or details that you think are relevant to the near miss incident. This could include photographs, witness statements, or any other supporting evidence.
5. Suggest improvements or corrective actions that can be taken to prevent similar incidents from happening again. These suggestions should be practical and actionable.
6. Sign and date the safety suggestion near miss form to indicate that you are the submitter. This will also serve as a reference for future communication or follow-ups.

Who needs safety suggestion near miss?

1. Employees: It is essential for all employees to be aware of near miss incidents and potential hazards in the workplace. This will help them stay vigilant, take proactive measures, and contribute to a safer working environment.
2. Supervisors and Managers: They need to be informed about near miss incidents so that they can investigate the root cause, implement corrective actions, and ensure the safety of their team members.
3. Safety Committees: These committees play a crucial role in reviewing safety suggestions and near miss incidents. They can contribute by analyzing trends, identifying patterns, and implementing preventive measures on a broader scale.
4. Health and Safety Representatives: They need to be aware of near miss incidents to fulfill their role in ensuring a safe work environment. They may provide guidance, support, and advice to employees and management regarding safety improvements.

Remember, the purpose of a safety suggestion near miss is to prevent accidents, injuries, and property damage. By filling out the form accurately and providing relevant information, you contribute to creating a safer working environment for everyone.

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What is safety suggestion near miss?

A safety suggestion near miss is a report of an incident or situation that could have potentially resulted in harm or damage, but was fortunately avoided.

Who is required to file safety suggestion near miss?

All employees are encouraged to file safety suggestion near miss reports if they witness or experience a near miss incident.

How to fill out safety suggestion near miss?

Safety suggestion near miss reports can be filled out online on the company's safety portal or through a designated form that can be submitted to the safety department.

What is the purpose of safety suggestion near miss?

The purpose of safety suggestion near miss is to identify potential hazards or weaknesses in the safety protocols and procedures in order to prevent future accidents or incidents.

What information must be reported on safety suggestion near miss?

The information that must be reported on safety suggestion near miss includes details of the near miss incident, location, date and time, individuals involved, and any contributing factors.