Near Miss Form – Anonymous This Near Miss Form is totally anonymous and will help us to understand the type of risks our workforce have to deal with on site but are not necessarily spoken about or reported back to the supervisors or managers.Thank you very much for taking the time to share your experiences with us!Location (please select the location that is closest to your general area of working)* Poole, Bournemouth & Southampton Dorchester, Weymouth & Bridport Please tell us about your near miss in as much detail as you can remember.Did this happen:* Very recently This year Within the last 5 years A long time ago – more than 5 years. Would you like to add a photo?:Max. file size: 2 MB.Are there any actions required that you feel can remove/reduce this risk?If you have a safety concern at work, do you feel listened to by the site supervisors, managers etc?Date* DD slash MM slash YYYY
