Hazard Report Form

What a hazard report is and why it matters

A hazard report is how you turn something you have noticed on site into a record that can be acted on. Instead of relying on memory or a verbal comment, you set out what the hazard is, where it is, why the situation is dangerous, and how serious the outcome could be. The act of writing it down also forces you to say whether your supervisor or manager has been informed, which keeps the right people in the loop early. The report is not only a description. It captures your judgement about the injury that could result and the likelihood that the injury would be that severe, so the people who decide what to do next have both the facts and your assessment in front of them. On this checklist those two judgements are recorded separately. It also carries the fix. The Corrective Action section records the corrective action to be taken to reduce the risk and put effective control measures in place, confirms that the corrective action has been recorded, and records the action taken to correct the hazard and reduce the risk. It then checks whether corrective actions have been taken and whether control measures have been implemented. That loop closes the report only once the hazard has actually been dealt with.

What a good hazard report covers

A good report is specific enough that someone who was not there can understand it. It covers: - **The basics**: when it was conducted, who prepared it, and where the hazard is located. - **A description of the hazard**: what you actually saw or found. - **Why the situation is dangerous**: the reason the hazard could cause harm. - **Severity**: what the severity of the injury could be. The checklist's rating scale for this covers *First aid required*, *Serious injury*, *Long-term illness*, and *Permanent disability*. - **Likelihood**: what the likelihood is that the injury would be that severe, rated from *Very likely*, *Likely*, *Unlikely*, to *Very unlikely*.

How to work through the checklist

1. **Hazard Report.** Record when the report is conducted, who prepared it, and where the hazard is located. Answer whether you have informed your supervisor or manager. Describe the hazard. Explain why the situation is dangerous. Record what the severity of the injury could be, and the likelihood that the injury would be that severe. 2. **Corrective Action.** Record the corrective action to be taken to reduce the risk and put effective control measures in place. Confirm that the corrective action has been recorded. Record the action that has been taken to correct the hazard and reduce the risk. Answer whether corrective actions have been taken, and whether control measures have been implemented. 3. **For the Supervisor / Manager.** Record the signature. Finish with the finished time and the actual inspection start and end dates, so the timeline of the report is preserved.

Where the checklist fits

The checklist does not replace your judgement or your organisation's procedures. It gives that work a fixed shape: the same fields, the same rating scales, and a single place where the hazard, the assessment, and the corrective action sit together. Because the items call for all three, a report that stops halfway is visible as such rather than being mistaken for a completed one.

How to use the hazard report checklist

Use the checklist at the point where you observe the hazard, so the time, place, and description are recorded while they are still fresh. Complete the rating scales as they are written rather than paraphrasing them. Where an item does not apply, use the *Not applicable* option so the record distinguishes between 'not relevant' and 'not done'. Complete the corrective action entries and the confirmation items before seeking the supervisor or manager signature, and record the finished time and the actual start and end dates at the end.

Frequently Asked Questions

The checklist runs in three parts. The Hazard Report section records when the report is conducted, who prepared it, and where the hazard is located, whether the supervisor or manager has been informed, a description of the hazard, why the situation is dangerous, and an assessment of the severity of the potential injury and the likelihood that an injury would be that severe. The Corrective Action section records the corrective action to be taken to reduce the risk and put effective control measures in place, confirms that the action has been recorded, and records the action taken to correct the hazard and reduce the risk, whether corrective actions have been taken, and whether control measures have been implemented. A supervisor or manager then signs off in the final section. Across the 17 items, answers are given on rating scales covering options such as Yes, No and Not applicable; First aid required, Serious injury, Long-term illness and Permanent disability; Very likely to Very unlikely; and Compliant, Non-compliant and Not applicable.

You begin with the Hazard Report section, recording when the report is conducted, who prepared it, and where the hazard is located. You record whether the supervisor or manager has been informed, describe the hazard, and explain why the situation is dangerous. You then assess the severity of the potential injury and the likelihood that an injury would be that severe. From there you move into the Corrective Action section, recording the corrective action to be taken to reduce the risk and put effective control measures in place, confirming that it has been recorded, and recording the action actually taken. You confirm whether corrective actions have been taken and whether control measures have been implemented. The final section, For the Supervisor / Manager, carries the sign-off, and the report is closed out with the finished time and the actual inspection start and end dates.

Yes. The report captures who prepared it and the location of the hazard, whether the supervisor or manager has been informed, and a description of the hazard. It also records the severity of the potential injury and the likelihood that an injury would be that severe, so the report preserves both what was observed and how serious it could be.

The Corrective Action section records the corrective action to be taken to reduce the risk and put effective control measures in place, confirms that the corrective action has been recorded, and records the action taken to correct the hazard and reduce the risk. It then confirms whether corrective actions have been taken and whether control measures have been implemented, so the report stays open until the risk has been addressed.

The finish time and the actual inspection start and end dates are recorded, so the timeline of the report is captured alongside the hazard description and the corrective action.

Written by

Arne Reis

Founder

Process optimizer with 25 years of expertise, focused on operational excellence in quality, maintenance, EHS, and commissioning. Emphasizes innovative solutions and top-quality standards.

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