Health & safety
Near Miss / Incident Report template
Capture what happened on site, the people involved and the action taken while the details are fresh. A factual report supports internal follow-up but does not determine whether a separate statutory report is required.
Blank printable PDF: Classic style with the JobForms badge. No sign-up needed.
What's on this sheet
JobForms
Near Miss / Incident Report
Job ref: __________
Details
Type
Choose one
□ Near miss□ Injury□ Damage□ Unsafe condition□ Environmental
Date
Date
Time
Time
Location
Site / address
Short answer
Exact location
Short answer
People involved
Short answer
What happened
Description
Notes
Injuries / damage (if any)
Notes
First aid given
Choose one
□ Yes□ No□ N/A
Immediate action taken
Notes
How to stop it happening again
Notes
Photos
Photos of scene
Photos · capture stamps
Sign off
Reported by
Short answer
Signature
Signature
Manager name
Short answer
Manager signature
Signature
Classic printable sheet · Powered by JobForms
Who uses it
Health & Safety teams and UK businesses keeping a clear visit or check record. Record a near miss, accident or damage quickly on site, with photos and actions.
Explore this industry’s formsCommon questions
Is this health & safety sheet a certificate?
Tailor the record to the actual task and use your site’s authorised safety procedures. A template does not replace a competent assessment.
Can I print it or fill it on my phone?
Download the blank Classic PDF without signing up, or fill a copy in guest mode on your phone. Photos and signatures are available when filling digitally.
What is included on the Free plan?
Free includes Classic PDFs with the JobForms badge, up to 3 custom templates, 20 jobs per calendar month and 1 shared form. Other PDF styles and custom PDF branding are paid features.
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