Occupational Safety and Fire Prevention

Near-Miss Hazard Reporting

The Near-Miss Hazard reporting form is designed to encourage early detection and correction of hazards or potential hazards.  Hazard elimination or control is the primary focus of Environmental Health and Safety (EHS) injury and prevention programs.

The Near-Miss Hazard Report form only applies to building and grounds located on the Galveston Texas campus.  Concerns with offsite facilities are to be reported to the offsite facility manager.

The Near-Miss Hazard Report form gives UTMB employees and students a convenient method to identify a potential hazard or a near miss.  Employees can communicate this information to EHS for review and evaluation.

Life Threatening or Imminent Danger Hazards

Immediately contact UTMB Campus Police (772-1111) AND Environmental Health and Safety (747-0515). 

After hours contact the FOAM Control Room at 772-1586.

This form may be completed by an employee or a student who is either concerned about a potential hazard or has experienced a near miss (i.e. an incident that could have resulted in an injury or exposure).

Make sure to check the Report Updates page to see the status of your report or to see if someone has already reported your concern.  Some items will take longer to resolve than others, but the Report Updates page will be updated on a regular basis.

If an Employee is involved...and you wish to call in the incident instead of using the form below, please call EHS (409) 747-0515.

If a Patient is involved...report directly to Risk Management by using the UTMB Occurrence Report, or by calling (409) 772-4775.

Go to the Near-Miss Hazard Report Form

Near-Miss Hazard Report Updates

Last updated 2/6/04