(Guidelines from the NDSU University Police and Safety Office.)

A near miss is a potential hazard or incident that has not resulted in any personal injury. Unsafe working conditions, unsafe employee work habits, improper use of equipment, or use of malfunctioning equipment have the potential to cause work related injuries. It is everyone’s responsibility to report and/or correct these potential accidents/incidents immediately. Please complete the Near Miss Reporting Form to report these situations.

• Within 3 working days of the incident, the employee will file a Near Miss Reporting Form with his/her immediate supervisor.
• The supervisor will complete the Supervisors portion of the form. As a part of this process, the supervisor assesses the near miss incident and if warranted, takes corrective action.
• Give the completed Near Miss Reporting Form to the Administrative Assistant, who will file it with the NDSU University Police and Safety Office.