Create a Near Miss Report Form using Google Forms

Capture near-miss events that could have resulted in injury, damage, or loss to stay proactive and prevent accidents before they happen.

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Reviews 30

Create a Near Miss Report Form using Google Forms

Capture near-miss events that could have resulted in injury, damage, or loss to stay proactive and prevent accidents before they happen.

What is a near miss report form?

A near miss report is used to document close calls, hazardous situations, or unsafe conditions that could have caused injury, illness, or property damage. These reports are a critical part of any workplace safety program because they help organizations identify hidden hazards, address risks, and prevent accidents before they occur. By analyzing near misses, safety teams can take corrective actions and improve procedures to protect employees and assets.

Key components

A comprehensive Near Miss Report Form should collect all essential information clearly, accurately, and in a structured format that supports workplace safety management. The form should include the following sections:

Reporter Information: This section collects details about the person submitting the near miss report. It includes the reporter’s full name, job title, department, and contact information. Accurate reporter information ensures accountability and proper follow-up.
Near Miss Details: This section records when, where, and what type of near miss occurred. Include the date, time, and specific location of the potential incident. Provide a factual and detailed description of the event, including the sequence of events, actions taken to avoid the incident, and any contributing factors.
Risk Assessment: Evaluate the potential impact of the near miss if it had resulted in an accident. Include the severity and likelihood of harm, helping the safety team prioritize corrective actions and preventative measures.
Corrective and Preventive Actions: Document the steps taken to address the incident and prevent future occurrences. This includes both immediate corrective actions and long-term preventive recommendations. Identify the individuals responsible and specify target or completion dates for each action.
Attachments: Include supporting evidence such as photos, videos, diagrams, or documents that help illustrate the near miss and provide context for analysis.
Acknowledgement: Collect signatures from the reporter and supervisor or safety officer to verify the accuracy of the information. This completes the approval workflow, ensuring accountability and formal documentation for recordkeeping purposes.

Key features & benefits

Regulatory Compliance: Near miss reports help organizations meet workplace safety regulations and internal safety policies by ensuring all critical details of potential incidents are captured accurately.

Upload Attachments: Include photos or documents showing hazards, unsafe behaviors, near misses, or work areas to provide clear evidence and context. This makes reporting more thorough and actionable.

Legally Binding Signatures: Collect signatures from employees and supervisors to maintain accountability and formal verification. Signed near miss reports can serve as official records for internal safety audits or investigations.

Customizable Approval Workflow: Route near miss reports to supervisors, safety officers, or management for review, verification, and follow-up. This streamlines hazard management and ensures corrective actions are assigned and tracked.

Sync to Google Sheets: Sync form responses directly to Google Sheets to track near miss events, analyze trends, monitor recurring hazards, and generate data-driven safety insights for continuous improvement.

Save to Google Drive: Automatically generate and store PDF copies of near miss reports in Google Drive for easy access, organized recordkeeping, and long-term documentation.

Privacy & Security: Near miss reports may include sensitive details. Restrict access to protect confidentiality while maintaining transparency for safety management.

Mobile-Friendly: Enable employees to submit near miss reports directly from mobile devices, including photos or documents, for faster and more accurate reporting on-site.

Conclusion

Whether you are managing a construction site, healthcare facility, manufacturing plant, or office environment, using a standardized Near Miss Report Form ensures consistent documentation and supports workplace safety compliance. This template simplifies the reporting process, helping employees and supervisors capture essential details about close calls, hazardous situations, and unsafe conditions as soon as they occur, when information is most accurate and actionable.

Create your customized Near Miss Report Form to make reporting faster, easier, and more effective in preventing accidents and promoting a safer workplace.

These reviews are reproduced without modification from Google Workspace Marketplace.

5 stars

I chose Formesign because I needed a solution to link forms with signature capabilities. We are in the home service business and have a very large fleet of field operators. Formesign ability to link forms and gather signatures has removed the intense manual collection of this process out of our operation. Specifically, Vipin on the support side of Formesign has been valuable in advising on flow and making sure the process is lean. Formesign is...plug and play. Thank you!

Jason Crossen

November 1, 2025

5 stars

Absolutely brilliant!!!! Game changer! Awesome support!

andre girardeau

October 14, 2025

1 stars

Besides the fact that one gets billed $216 monthly, Support took a long time to try and get things to work. Trying to get things signed on a form was such an issue and through out formatting. Way over priced, support that you have to wait till the next day to get one thing sorted and not sorted, back and forth the whole time. Frustrating customers and damage to business. I will not reccommend this company to anyone. Try JotForms so much better, and you can do much more for a fraction of the cost per year not per month.

Francois Ohsiek

May 30, 2025

Hi Francois, sorry you had a frustrating experience with the formatting. Just to clarify, the plan you’re on is $216 per year, not per month. You signed up for the Formesign Esignature paid plan on May 8, 2024, and since you also needed to sign agreements, we provided access to our Formesign - Fillable PDF add-on at no extra cost. Regarding formatting: when working with Google Docs templates, we recommend using lists instead of indents and setting up layouts with tables for images, rather than inserting images directly. This helps maintain proper formatting. To assist, we also created and shared a sample template as a reference. You had asked us to make edits on your behalf, which we’re not able to do for security reasons. However, we did reach out and invited you to join a scheduled Zoom call to walk through the process — as we’ve done several times over the past year — but we didn’t receive a response. Update: To make things easier for all users, we have just launched the new document editor in Formesign that will allow agreements to be created directly, without relying on Google Docs.

— Formfacade

June 3, 2025

2 stars

The platform is good but promises one week of premium usage based on which I chose it. Once my form was sent out to participants, it capped the responses at 24 and I was forced to pay 36 USD to keep the form active. Really disappointed by the lack of clarity and the overly tight response numbers for each tier of the plan considering how nice the platform could be.

Nishka Khendry

September 11, 2025

5 stars

I am not tech savvy. I chose formesign to help create registration links for clients. Vipid has been great in assisting me. He goes above and beyond. My company now has moved from the stone age to modern age through the ability to use this feature. Of the many features I am impressed with, the ability to update a form without needing to regenerate a link is amazing. I often make mistakes and that ability allows me to fix mistakes without needing to change everything. Thank you!!!

Sol Evans

July 23, 2023

5 stars

It very friendly to used. I love it. For my case multiple signature needed. it's supporting

Senthil Kumar

July 12, 2023

5 stars

Yeah this is good for all

luqman Khan

November 27, 2023

1 stars

Does not work

Myles Sicuro

February 16, 2024

5 stars

We were looking for a way to have a signature option in our form. Formesign addon allowed us to collect signatures for the acknowledgment and consent forms. It was simple and easy to setup. Very useful addon for google forms.

Joan S

July 10, 2023

Create a Near Miss Report Form using Google Forms