Get Navy Mishap Report

The Navy Mishap Report is a crucial document for reporting incidents within the Navy, enabling effective tracking and analysis of mishaps. This guide provides clear instructions on how to complete the form online, ensuring accurate and timely reporting of incidents.

Follow the steps to fill out the Navy Mishap Report effectively

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Select the mishap type by checking the appropriate block. Options include injury, illness, and property damage. Make sure to refer to the appropriate instructions for crane incidents if applicable.
3. Fill in the name of the injured employee, ensuring to include the last name, first name, and middle initial.
4. Input the date and time of the mishap accurately.
5. Specify the geographic shop and resource shop related to the incident.
6. Enter the date of report submission.
7. Document the type of injury experienced, such as sprain, cut, or bruise, and identify the body part affected.
8. Indicate the application area where the mishap occurred.
9. Provide the job title of the individual involved in the mishap.
10. If the incident was a near miss, indicate so accordingly.
11. Specify the safe site and the exact location where the mishap occurred.
12. Identify the integrated product team where the incident took place and include the building number.
13. Document any equipment involved or damaged, including plant account number, model number, and serial number.
14. Detail the chain of events leading up to, during, and following the mishap, ensuring to answer who, what, when, where, and how.
15. Record the supervisor's recommended corrective actions.
16. Indicate whether proper procedures were followed by choosing yes or no. If no, provide a brief explanation.
17. Confirm if proper personal protective equipment (PPE) was worn and indicate yes or no.
18. Specify if the mishap was reported by the end of the shift, and if not, give a reason.
19. List the names and phone numbers of any witnesses to the incident.
20. Finally, provide the supervisor's name, shop, and phone number.
21. Ensure an electronic copy is sent to the designated competency lead, AA champion, and safety team leads.
22. Once all information is completed, save your changes. You may also choose to download, print, or share the form as needed.

Complete your Navy Mishap Report online today to ensure safety and accountability.