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Hazard & Near-Miss Reporting
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What's the difference between a Hazard and a Near Miss?
Hazard
Anything that has the potential to cause injury or disease to people or damage the environment, property or equipment.
Example: A slippery set of stairs is a hazard.
Near Miss
An occurrence that could have led to unintended and/or unnecessary harm to a person, and/or a complaint, loss or damage.
Example: Somebody slips on the stairs but is not injured.
Remember:
Near Miss
= an incident without injury
Near-Miss Incident Report
No.: New
Date Submitted:
06-05-23
SUBMITTER
Select Role
Employee
Student
Visitor
Select new
Abair, Kj
Anderson, Jill
Avery, Jamie
Barnes, Angelina
Barnes, Julie
Becker, Laura
Bender, Kris
Bernal, Ellen
Bettinger, Kristi
Bialecki, Jamie
Black, Samantha
Bollinger, Jennifer
Bostwick, Amy
Bostwick, Ellen
Bower, Tim
Brighton, Matthew
Brown, Kolina
Brown, Laura
Buchhop, Theresa
Buckenmeyer, Jennifer
Buckenmeyer, Tonya
Burgoon, Jayme
Burkhart, Bethany
Butler, Katie
Bzovi, Morgan
Cales, Shelly
Carrisalez, Heather
Carrisalez, Sam
Carrizales, Megan
Chiesa, Kara
Cogan, Melissa
Conrad, Adam
Cook, Mark
Creighton, Kellie
Currier-ford, Mary kathryn
Damman, Peggy
Daniels, Deborah
Davis, Ryan
Dixon, Deedra
Durdel, Linda
Durfey-dzenis, Gail
Ebaugh, Bronson
Egan, Michelle
Eisel, Lance
Elliott, Daniel
Engel, Michele
Falor, Janet
Feasel, Matt
Finnen, Kelly
Flores, Jammie
Flory, Andrea
Foor, Jane
Ford, Doug
Ford, Jessica
Ford, Meredith
Fox, Nathan
Freado, Michael
Freemain, Gabriel
Freeman, Kevin
Freeman, Terrie
Friess, Derek
Fuerstenau, Sarah
Gaynor, Ginny
Gibson, Jack
Gilbert, Jessica
Gillen, Jennifer
Gillen, Kelsey
Gross, Kim
Gutowitz, Wendy
Hallett, Cathy
Hamilton, Katie
Hanak, William
Harper, Sheri
Hasapes, Connie
Haselman, Ted
Hawkins, Laura
Heban, Dennis
Heisinger, Kathleen
Helminiak, Shawna
Hess, Michele
Hildreth, Rachel
Histed, Bruce
Hoff, Rebecca
Hoffman, Amanda
Hoffman, Stefanie
Holzhauer, Jenna
Jackson, Randy
Jacob, Janet
James, Nicole
Jeffers, Jeanne
Johnson, Andrea
Juby, Beth
Kane, Renee
Kennedy, Samantha
Kina, Dave
Kohlhofer, Frank
Kramer, Amy
Kravetsky, Ashley
Lamb, Ryan
Lintermoot, Amy
Lintermoot, Randy
Lohman, Diane
Lutheran, Kim
Marteny, Dustin
Mattin, Dawn
Mayhart, Jennifer
Mazurowski, Jeff
Mazurowski, Jennifer
Meiring, Dana
Mewborn, Kim
Mewborn, Nick
Mignin, Jon
Mignin, Kirsten
Miller, Jamie
Miller, Natalie
Mitchell, Lee
Moore, Charlie
Morstadt, Caylin
Myers, Michelle
Nagel, Mark
Nyquist, Wendy
Olejniczak, Erin
Patterson, Deborah
Paul, Janet
Peckinpaugh, Becky
Peper, Kaeden
Pezzin, Phyllis
Polsdorfer, Alexa
Polsdorfer, Haley
Popovich, Tiisha
Price, Anita
Rayfield, Ryan
Riegsecker, Mildred
Ripke, Ryan
Risner, Elizabeth
Robertson, Eric
Roe, Lindsay
Roth, Amy
Rouleau, Ronald
Ruple, Nathan
Savage, Amber
Schaffner, Vicki
Scherer, Tammy
Schmidt, Heather
Schmidt, Mary
Schmude, Lisa
Schulze, Jesse
Sheakley, Curtis brannon
Shelt, Michelle
Siler, Baylee
Siler, Emma
Simmons, Deeann
Simon, Alice
Simon, Kerri
Smith, Chad
Smith, Jeff
Smith, Peggy
Smith, Sharon
Snyder, Lisa
Soto, Tiffany
Spieth, Amy
Starr, Susan
Steele, Walter
Steward, Bonnie
Stickley, Dustin
Stickley, Michelle
Sutton, Brandi
Swicegood, Dawson
Taft, Barbara
Tenney, Scott
Thomas, Arthur
Tolson, Audra
Tolson, Tammy
Tresnan-reighard, Mary
Triana, Paige
Turi, Michael
Valentine, Kelly
Valerius, Cathy
Vanderveer, Katrina
Vasquez debustamante, Claudia
Viveros, Ashley
Wagner, Benjamin
Waite, Laura
Waugh, Pamela
Webster, Stephanie
Williams, Hannah
Williams, Heather
Willman, Lindsay
Winterfeld, Jon
Wolford, Jeff
Wolford, Jennifer
Wolford, Jordyyn
Woodring, Todd
Wymer, Braelyn
Wyse, Kelly
Young, Johanna
Zdunczyk, Ronald
First Name
Last Name
Telephone No.
(optional)
Email Address
(required if email turned on below)
DESCRIPTION
Describe the Near-Miss Incident
Attachments
Add Attachment
Describe how the incident happened, including what you were doing before and at the time of the incident, personal protective equipment being used, and any tools, equipment or materials involved.
LOCATION OF NEAR-MISS INCIDENT
Site
Athletic building - fb
District Office
Elementary School
Grounds
High School
Middle School
pre school
Transportation Building
Building
Where in the Building
It is important that you accurately describe where the near-miss incident occurred. This information may be valuable in correcting issues needed to avoid future accidents.
ASSIGNEE
Abair, Kj
Anderson, Jill
Avery, Jamie
Barnes, Angelina
Barnes, Julie
Becker, Laura
Bender, Kris
Bernal, Ellen
Bettinger, Kristi
Bialecki, Jamie
Black, Samantha
Bollinger, Jennifer
Bostwick, Amy
Bostwick, Ellen
Bower, Tim
Brighton, Matthew
Brown, Kolina
Brown, Laura
Buchhop, Theresa
Buckenmeyer, Jennifer
Buckenmeyer, Tonya
Burgoon, Jayme
Burkhart, Bethany
Butler, Katie
Bzovi, Morgan
Cales, Shelly
Carrisalez, Heather
Carrisalez, Sam
Carrizales, Megan
Chiesa, Kara
Cogan, Melissa
Conrad, Adam
Cook, Mark
Creighton, Kellie
Currier-ford, Mary kathryn
Damman, Peggy
Daniels, Deborah
Davis, Ryan
Dixon, Deedra
Durdel, Linda
Durfey-dzenis, Gail
Ebaugh, Bronson
Egan, Michelle
Eisel, Lance
Elliott, Daniel
Engel, Michele
Falor, Janet
Feasel, Matt
Finnen, Kelly
Flores, Jammie
Flory, Andrea
Foor, Jane
Ford, Doug
Ford, Jessica
Ford, Meredith
Fox, Nathan
Freado, Michael
Freemain, Gabriel
Freeman, Kevin
Freeman, Terrie
Friess, Derek
Fuerstenau, Sarah
Gaynor, Ginny
Gibson, Jack
Gilbert, Jessica
Gillen, Jennifer
Gillen, Kelsey
Gross, Kim
Gutowitz, Wendy
Hallett, Cathy
Hamilton, Katie
Hanak, William
Harper, Sheri
Hasapes, Connie
Haselman, Ted
Hawkins, Laura
Heban, Dennis
Heisinger, Kathleen
Helminiak, Shawna
Hess, Michele
Hildreth, Rachel
Histed, Bruce
Hoff, Rebecca
Hoffman, Amanda
Hoffman, Stefanie
Holzhauer, Jenna
Jackson, Randy
Jacob, Janet
James, Nicole
Jeffers, Jeanne
Johnson, Andrea
Juby, Beth
Kane, Renee
Kennedy, Samantha
Kina, Dave
Kohlhofer, Frank
Kramer, Amy
Kravetsky, Ashley
Lamb, Ryan
Lintermoot, Amy
Lintermoot, Randy
Lohman, Diane
Lutheran, Kim
Marteny, Dustin
Mattin, Dawn
Mayhart, Jennifer
Mazurowski, Jeff
Mazurowski, Jennifer
Meiring, Dana
Mewborn, Kim
Mewborn, Nick
Mignin, Jon
Mignin, Kirsten
Miller, Jamie
Miller, Natalie
Mitchell, Lee
Moore, Charlie
Morstadt, Caylin
Myers, Michelle
Nagel, Mark
Nyquist, Wendy
Olejniczak, Erin
Patterson, Deborah
Paul, Janet
Peckinpaugh, Becky
Peper, Kaeden
Pezzin, Phyllis
Polsdorfer, Alexa
Polsdorfer, Haley
Popovich, Tiisha
Price, Anita
Rayfield, Ryan
Riegsecker, Mildred
Ripke, Ryan
Risner, Elizabeth
Robertson, Eric
Roe, Lindsay
Roth, Amy
Rouleau, Ronald
Ruple, Nathan
Savage, Amber
Schaffner, Vicki
Scherer, Tammy
Schmidt, Heather
Schmidt, Mary
Schmude, Lisa
Schulze, Jesse
Sheakley, Curtis brannon
Shelt, Michelle
Siler, Baylee
Siler, Emma
Simmons, Deeann
Simon, Alice
Simon, Kerri
Smith, Chad
Smith, Jeff
Smith, Peggy
Smith, Sharon
Snyder, Lisa
Soto, Tiffany
Spieth, Amy
Starr, Susan
Steele, Walter
Steward, Bonnie
Stickley, Dustin
Stickley, Michelle
Sutton, Brandi
Swicegood, Dawson
Taft, Barbara
Tenney, Scott
Thomas, Arthur
Tolson, Audra
Tolson, Tammy
Tresnan-reighard, Mary
Triana, Paige
Turi, Michael
Valentine, Kelly
Valerius, Cathy
Vanderveer, Katrina
Vasquez debustamante, Claudia
Viveros, Ashley
Wagner, Benjamin
Waite, Laura
Waugh, Pamela
Webster, Stephanie
Williams, Hannah
Williams, Heather
Willman, Lindsay
Winterfeld, Jon
Wolford, Jeff
Wolford, Jennifer
Wolford, Jordyyn
Woodring, Todd
Wymer, Braelyn
Wyse, Kelly
Young, Johanna
Zdunczyk, Ronald
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