Free Printable Near-Miss Report Form - Construction Safety PDF

A near-miss report form for jobsite hazard follow-up

A near-miss report form helps construction and trades teams document hazards, almost-incidents, immediate action, witnesses, and follow-up before someone gets hurt.

Potential injury and Immediate action help supervisors see both the seriousness of the event and what was done right away to reduce risk.

Use this printable with your safety program, company reporting chain, OSHA or local requirements, and emergency procedures. It is not a substitute for required incident reporting.

Practical setup tips

Before printing the Near, decide what one row represents and how often the page will be reviewed. That keeps the sheet from becoming a catch-all notes page and makes the finished record easier to compare with similar pages in the same binder or workflow.

• Date / location should be filled in consistently so the sheet remains useful after the first day of use.
• Hazard / event should be filled in consistently so the sheet remains useful after the first day of use.
• Potential injury should be filled in consistently so the sheet remains useful after the first day of use.
• Immediate action should be filled in consistently so the sheet remains useful after the first day of use.
• Witness should be filled in consistently so the sheet remains useful after the first day of use.
• Follow-up should be filled in consistently so the sheet remains useful after the first day of use.

If the printable is part of a formal, financial, medical, legal, or compliance workflow, use it as a planning and note-taking aid alongside the official system or professional guidance that applies to your situation.