This incident reporting template is a ready-made Google Docs form for supervisors who need to record an event that nearly caused harm within the same shift. It walks through what happened, the potential harm, the cause and the suggested fix across six designed pages, in time order and without blame.

Each page carries a sample event for Orrindale Works, a fictional warehouse, in which a pallet slid from a rack onto an empty walkway. Replace the event, scores and fixes with your own, and keep the separation between facts and causes. The shift-start briefing at the end is what turns a report into a change.