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Safety / Near-Miss Report

Log near-misses with severity, immediate actions, and a clear follow-up owner—fast.

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constructionmanufacturinglogisticssafetyincident
Use this whenever something almost went wrong. The goal is to capture enough context to prevent repeats.

Form preview

Incident
Site / Location
TextRequired
Where did it happen?
[not set]
Occurred At
Date & TimeRequired
When did it happen?
📅⏰ Date & time
Category
TextRequired
Type of hazard
Options: Slip/Trip, Vehicle, Tools, Electrical, Chemical, Other
[not set]
▼
Severity
TextRequired
How serious was it?
Options: Low, Medium, High, Critical
Low
Medium
High
Critical
What Happened
Text AreaRequired
Short factual description
Short factual description
Photos
Photo
Add supporting photos
No photos captured
Actions
Immediate Action Taken
Text Area
What did you do right away?
What did you do right away?
Follow-Up Owner
TextRequired
Who owns the follow-up?
[not set]
Follow-Up Due
Date
When should it be closed?
📅 Select date
EXAMPLE REPORTSample data — shows what you’ll get after recording

Example filled report

Incident
Site / Location
Warehouse West - Dock Door 3
Occurred At
02/05/2026 9:35 AM
Category
Vehicle
Severity
High
What Happened
Forklift reversed out of dock lane while a picker was crossing. No contact, but the distance was under 1 meter.
Photos
Add supporting photos
No photos captured
Actions
Immediate Action Taken
Stopped forklift traffic for 5 minutes, reviewed crossing rules with driver and team, and placed a temporary cone barrier.
Follow-Up Owner
Shift Supervisor (Mario)
Follow-Up Due
02/06/2026
Safety / Near-Miss Report | Voiz Report Templates