Get Near Miss Report Form

Filling out the Near Miss Report Form online is a crucial step in enhancing safety and preventing future incidents. This guide will walk you through the necessary steps to complete this form efficiently and accurately.

Follow the steps to fill out the Near Miss Report Form online.

1. Click ‘Get Form’ button to access the form and open it for editing.
2. Enter the near miss incident date and time at the top of the form. Ensure that these fields are filled out accurately to provide a clear timeline of the incident.
3. Fill in the reporting date and time to document when you are completing the report. This information helps track when the report was submitted.
4. Specify your Council/BSA location. This field is essential for identifying the geographic context of the incident.
5. Indicate the reporting person. Select from the designated categories: 'Leader,' 'Parent,' or 'Other.' If applicable, provide the reporting person's contact information for follow-up.
6. Describe the location of the near miss and provide specifics on the area where the incident occurred. Clarity in location can aid investigations and future safety measures.
7. State the cause of the near miss. Be as detailed as possible to allow for better understanding and prevention of similar occurrences.
8. Enter the program/event/adventure code associated with the incident. If you are unsure, check organizational resources or consult with a supervisor.
9. Provide a detailed description of the near miss. This should include what happened, how it happened, and any other relevant information that could provide context.
10. Indicate whether the near miss occurred while transporting to or from an activity by selecting 'Yes' or 'No.' This information helps identify patterns of potential risk.
11. Assess the potential severity of the incident by selecting one of the provided options: 'Critical-II,' 'Catastrophic-I,' 'Marginal-III,' 'Negligible-IV,' or 'Unknown.' Refer to definitions provided on the form for clarification.
12. Reflect on lessons learned from the near miss and provide insights on what could be implemented to prevent future incidents.
13. List witnesses of the incident, if there are any. Ensure to include name, contact details, and relevant information for verification.
14. When you have completed all sections of the form, save your changes. You may also choose to download, print, or share the completed form as needed.
15. Return the completed form to your council's designated user for entry into RiskConsole via MyBSA Incident Entry.

Take action now by completing the Near Miss Report Form online to help improve safety measures!