Get the free Accident/Near Miss Report Form

Northumberland County Council Accident/Near Miss Report Form On-Line ACC1 LD April 2016 Private and Confidential Please refer to guidance note ACC1-G before completion and retain a copy of this form on site. Please complete all fields in the form as appropriate. After the form has been completed and signed by the appropriate officer s it should then be submitted to the Corporate Health and Safety Team at County Hall. Directorate Department Service Establishment/Base e.g. School ATC Depot...

How to fill out accidentnear miss report form

How to fill out accidentnear miss report form

1. Read the accident/near miss report form carefully to understand its purpose and requirements.
2. Provide your personal information such as name, contact details, and job position.
3. Describe the accident or near miss in detail, including the date, time, and location of the incident.
4. Explain the circumstances leading to the accident or near miss, including any contributing factors.
5. Provide information about any witnesses present at the scene.
6. Include a description of the injuries or damages caused by the accident or near miss.
7. Attach any relevant documents or evidence, such as photographs or videos.
8. Provide any additional information or comments that may be important for the investigation.
9. Review the filled form for accuracy and completeness before submitting it.
10. Submit the accident/near miss report form to the designated authority or department.

Who needs accidentnear miss report form?

1. Employees who witness or are involved in an accident or near miss incident at the workplace.
2. Supervisors and managers responsible for maintaining a safe work environment.
3. Health and safety officers in charge of analyzing and investigating incidents.
4. Companies and organizations aiming to improve safety protocols and prevent future accidents.

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What is accident/near miss report form?

The accident/near miss report form is a document used to report any accidents or near misses that occur in the workplace.

Who is required to file accident/near miss report form?

All employees are required to file an accident/near miss report form if they are involved in an accident or witness a near miss incident.

How to fill out accident/near miss report form?

To fill out the accident/near miss report form, employees must provide details about the incident, including what happened, where it happened, and any potential causes.

What is the purpose of accident/near miss report form?

The purpose of the accident/near miss report form is to document and investigate workplace incidents in order to prevent future accidents.

What information must be reported on accident/near miss report form?

The accident/near miss report form must include details such as the date and time of the incident, the location, any witnesses, and a description of what occurred.