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Tawa College Health & Safety - Near Miss Report
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Personal info
Name
*
Your answer
Email address
*
Your answer
Describe the near miss
Location of the near miss
*
Your answer
Date of near miss
MM
/
DD
/
YYYY
Time of near miss
*
Time
:
AM
PM
What happened?
Your answer
Suggestions to avoid the near miss in the future
Your answer
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