Near miss reporting
Accident Form
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Sanitising COSHH information
Near Miss Incident Reporting
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Name of person reporting the incident
*
First
Last
Please tick as appropriate
*
Teacher
Support Staff
Visitor
Cleaner
Date of incident
*
Please give a brief description of the near miss incident
*
Has this near miss incident happened to you before, or to anyone else that you are aware of? If yes, please provide details
Are there any other relevant points that you wish to note?
Email
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Name
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