Near-Miss Report Form

In the event of a serious accident or injury, or if there is an immediate threat to life, limb, or property, call 911. If possible, please reach out to the Campus Dispatcher at (937) 327-6363 after calling 911.

A near-miss is a potential hazard or incident in which no property was damaged and no personal injury was sustained, but where, given a slight shift in time or position, damage or injury easily could have occurred. Near misses also may be referred to as close calls, near accidents, or injury-free events. For the sake of a safe work environment, the company asks that all employees report these potential hazards immediately so that they may be corrected.

Please use the form below to report near-misses and assist us in preventing future incidents and making the company a safer work place. Near-miss reports will be sent to the Chemical Hygiene Officer.

If you have been injured or had an accident, this is not a near miss. No matter how insignificant an on-the-job injury may seem when it occurs, faculty, staff and student workers are required to notify their supervisor and the Human Resources Department. All reports should be made before leaving work on the day of the injury. This report is required by law and serves to protect your rights under the Workers' Compensation Act. Wittenberg Employees should contact Human Resources directly in the event of an injury or accident. Students and guests are encouraged to seek assistance at the Student Health and Wellness Center or one of the nearest clinics or hospitals. Wittenberg Police can assist with transportation for non-life threatening issues and minor injuries.

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