Accident, Incident, Near Miss Reporting

When an accident, incident or near miss is reported, injured persons receive timely medical care, unsafe conditions are quickly corrected, and the scene is preserved for review of potential claims. Incidents are reviewed to identify trends, effectiveness of current safety programs, and how to prevent similar incidents from reoccurring.


Sections 1&2 in the form may be completed by the person affected by the incident, a witness, a supervisor, or an instructor. Once the form has been submitted and received by the Environmental Health and Safety representatives, they will then review the form and investigate the incident. The individual who completed section 1&2 may be contacted by Environmental Health and Safety representatives involved in the investigation. ASSIGNING BLAME IS NOT THE PURPOSE OF THIS PROGRAM.


The University of New Haven Workplace Safety Program reviews information obtained in sections 1 & 2 of the Accident, Incident, and Near-Miss Report Form to determine if further investigation is needed. The goal of the investigation is to identify the root cause(s) of the incident and develop corrective actions that can be taken to prevent future occurrences.

The Environmental Health and Safety investigation team will complete their investigation and share the findings with the Safety Committee and all others employees involved. The involved parties will then sign off on all agreed upon corrective/preventative actions to help prevent future occurrences.