Step 1 — The event
The basics. Fill what you know — anything left blank is simply left off the report.
Step 2 — What type of event was it?
Pick all that apply. This is what keeps it fast — only the sets you choose open below.
Step 3 — What could have happened?
The point of a near-miss: the outcome you avoided.
Step 4 — Event deep-dive
These sections appear based on Step 2. Answer Yes / No / N/A — skip anything that doesn't apply.
Choose one or more event types in Step 2 and the matching questions open here.
Step 5 — Contributing factors (optional — tap to open)
The system side. Collapsed so the field crew can skip — open the ones worth digging into.
Step 6 — Root cause (the 5 whys)
Keep asking "why" until you reach the system, not just the person.
Step 7 — Stand-down discussion
Ask the crew directly. Capture what they say.
Step 8 — Corrective actions
Who does what, by when — and who verifies it's done.
Step 9 — Before work resumes
The forcing checklist. These always print on the report.
Step 10 — Documentation & sign-off
Step 11 — Download
We'll email you the report and occasional safety tips. No spam.
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