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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:
10-11-24
SUBMITTER
Select Role
Employee
Student
Visitor
Select new
Abair, Kj
Anderson, Jill
Avery, Jamie
Barnes, Angelina
Barnes, Julie
Becker, Laura
Behnfeldt, Brandon
Bender, Kris
Bernal, Ellen
Bettinger, Kristi
Bialecki, Jamie
Birr, Brianne
Bollinger, Jennifer
Bontrager, Logan
Brighton, Matthew
Brown, Laura
Buchhop, Theresa
Buckenmeyer, Jennifer
Buckenmeyer, Tonya
Burgoon, Jayme
Burke, Jonathan
Butler, Katie
Bzovi, Morgan
Cales, Shelly
Carrisalez, Kristen
Carrizales, Megan
Chiesa, Kara
Cogan, Melissa
Cornell, Emily
Creighton, Kellie
Culler, Dannica
Currier-ford, Mary kathryn
Dadisman, Rebecca
Damman, Peggy
Daniels, Deborah
Davis, Ryan
Dunford, Janey
Durdel, Linda
Durfey-dzenis, Gail
Egan, Michelle
Eisel, Lance
Engel, Michele
Finnen, Kelly
Flory, Andrea
Foor, Jane
Ford, Doug
Ford, Jessica
Ford, Ludmilla
Ford, Meredith
Fox, Nathan
Freado, Michael
Freeman, Gabriel
Freeman, Terrie
Friess, Derek
Fuerstenau, Sarah
Garcia, Nicole
Gilbert, Jessica
Gillen, Jennifer
Gillen, Kelsey
Gonzaez, Edgar
Gross, Kim
Hallett, Cathy
Hamilton, Katie
Harter, Debra
Hasapes, Connie
Hawkins, Laura
Hays, Leland
Helminiak, Shawna
Hess, Michele
Hildreth, Rachel
Hoff, Rebecca
Hoffman, Amanda
Hoffman, Stefanie
Hogrefe, Ashley
Jackson, Randy
Jacob, Janet
Jeffers, Jeanne
Juby, Beth
Karpuszka, Zachary
Kennedy, Samantha
Kmic, Mary
Kramer, Amy
Krise, Kiera
Lintermoot, Amy
Lohman, Diane
Lutheran, Kim
Mattin, Dawn
Mazurowski, Jeff
Mazurowski, Jennifer
McCarley, Kyle
Meiring, Dana
Mewborn, Kim
Mignin, Kirsten
Miller, Jamie
Myers, Michelle
Nagel, Mark
Nyquist, Wendy
Oates, Andrea
Olejniczak, Erin
Patterson, Deborah
Peckinpaugh, Becky
Peper, Kaeden
Pezzin, Phyllis
Plotts, Kylie
Price, Anita
Reckner, Justin
Ripke, Ryan
Robertson, Eric
Roe, Lindsay
Roth, Amy
Schaber, Brenda
Scherer, Tammy
Schmidt, Mary
Schmude, Lisa
Schultz, Daniel
Schultz, Pamela
Schulze, Jessie
Sheakley, Lori Hansel
Shelt, Michelle
Shepherd, Barbie
Siler, Emma
Siler Nofziger, Baylee
Simon, Kerri
Sintobin, Daniel
Smith, Chad
Smith, Peggy
Smith, Sharon
Snyder, Lisa
Soto, Tiffany
Spielvogel, Samuel
Starr, Susan
Steele, Walter
Steward, Bonnie
Stickley, Michelle
Stroud, Tiisha
Sutton, Brandi
Taft, Barbara
Tedrow, Tina
Tenney, Scott
Thomas, Arthur
Todd, Paige
Tolson, Audra
Tolson, Tammy
Tresnan-reighard, Mary
Triana, Paige
Turi, Michael
Valerius, Cathy
Vanderveer, Katrina
Vasquez debustamante, Claudia
Vent, Mallorie
Wagner, Benjamin
Waugh, Pamela
Winkler, Malorie
Wolford, Jeff
Wolford, Jennifer
Woodring, Todd
Wyse, Kelly
Wyse, Zack
Young, Johanna
Zdunczyk, Ronald
Zimmerman, Kristen
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
Behnfeldt, Brandon
Bender, Kris
Bernal, Ellen
Bettinger, Kristi
Bialecki, Jamie
Birr, Brianne
Bollinger, Jennifer
Bontrager, Logan
Brighton, Matthew
Brown, Laura
Buchhop, Theresa
Buckenmeyer, Jennifer
Buckenmeyer, Tonya
Burgoon, Jayme
Burke, Jonathan
Butler, Katie
Bzovi, Morgan
Cales, Shelly
Carrisalez, Kristen
Carrizales, Megan
Chiesa, Kara
Cogan, Melissa
Cornell, Emily
Creighton, Kellie
Culler, Dannica
Currier-ford, Mary kathryn
Dadisman, Rebecca
Damman, Peggy
Daniels, Deborah
Davis, Ryan
Dunford, Janey
Durdel, Linda
Durfey-dzenis, Gail
Egan, Michelle
Eisel, Lance
Engel, Michele
Finnen, Kelly
Flory, Andrea
Foor, Jane
Ford, Doug
Ford, Jessica
Ford, Ludmilla
Ford, Meredith
Fox, Nathan
Freado, Michael
Freeman, Gabriel
Freeman, Terrie
Friess, Derek
Fuerstenau, Sarah
Garcia, Nicole
Gilbert, Jessica
Gillen, Jennifer
Gillen, Kelsey
Gonzaez, Edgar
Gross, Kim
Hallett, Cathy
Hamilton, Katie
Harter, Debra
Hasapes, Connie
Hawkins, Laura
Hays, Leland
Helminiak, Shawna
Hess, Michele
Hildreth, Rachel
Hoff, Rebecca
Hoffman, Amanda
Hoffman, Stefanie
Hogrefe, Ashley
Jackson, Randy
Jacob, Janet
Jeffers, Jeanne
Juby, Beth
Karpuszka, Zachary
Kennedy, Samantha
Kmic, Mary
Kramer, Amy
Krise, Kiera
Lintermoot, Amy
Lohman, Diane
Lutheran, Kim
Mattin, Dawn
Mazurowski, Jeff
Mazurowski, Jennifer
McCarley, Kyle
Meiring, Dana
Mewborn, Kim
Mignin, Kirsten
Miller, Jamie
Myers, Michelle
Nagel, Mark
Nyquist, Wendy
Oates, Andrea
Olejniczak, Erin
Patterson, Deborah
Peckinpaugh, Becky
Peper, Kaeden
Pezzin, Phyllis
Plotts, Kylie
Price, Anita
Reckner, Justin
Ripke, Ryan
Robertson, Eric
Roe, Lindsay
Roth, Amy
Schaber, Brenda
Scherer, Tammy
Schmidt, Mary
Schmude, Lisa
Schultz, Daniel
Schultz, Pamela
Schulze, Jessie
Sheakley, Lori Hansel
Shelt, Michelle
Shepherd, Barbie
Siler, Emma
Siler Nofziger, Baylee
Simon, Kerri
Sintobin, Daniel
Smith, Chad
Smith, Peggy
Smith, Sharon
Snyder, Lisa
Soto, Tiffany
Spielvogel, Samuel
Starr, Susan
Steele, Walter
Steward, Bonnie
Stickley, Michelle
Stroud, Tiisha
Sutton, Brandi
Taft, Barbara
Tedrow, Tina
Tenney, Scott
Thomas, Arthur
Todd, Paige
Tolson, Audra
Tolson, Tammy
Tresnan-reighard, Mary
Triana, Paige
Turi, Michael
Valerius, Cathy
Vanderveer, Katrina
Vasquez debustamante, Claudia
Vent, Mallorie
Wagner, Benjamin
Waugh, Pamela
Winkler, Malorie
Wolford, Jeff
Wolford, Jennifer
Woodring, Todd
Wyse, Kelly
Wyse, Zack
Young, Johanna
Zdunczyk, Ronald
Zimmerman, Kristen
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