Workplace Incident and Near-Miss Report Forms: Functional Writing, Job Skills, Ages 14 to 21

Workplace Incident + Near Miss Report Forms: a functional reading and writing set for high school life skills, special education, and transition programs. Read the scene, choose the right form, and write what happened, where, when, and who you told.

Why I made this: Job site supervisors kept telling me the same thing: students do the work well, but when something small goes wrong, they do not say anything. I made this to practice the habit of telling the supervisor first and then writing a clear report.

How it is different from my Community + Workplace Safety Signs Task Cards: that set teaches reading safety signs. This set is about reporting after something happens, with employee forms, and has no sign reading.

What's included:

• A teacher page: why I made it, how to use both levels, and the skills covered

• Words to know: 10 key words, each with a picture

• 4 pages of practice documents: six made up workplace scenes, a blank employee incident report and a blank near miss report, and a "tell your supervisor first" page with a which form chart. All businesses, names, and numbers are made up.

• 12 Level A questions, each with a picture and three answer choices

• The same 12 questions at Level B, with open answers and room to show the math

• A real life task: fill out a form in full sentences, then ask your own job site who to tell and where the forms are kept

• An answer key that shows where to find each answer

How I use it: Read through the practice documents together, then give each student the level that fits. Both levels ask the same questions, so the whole class can check answers together. I use the real life task as a wrap up or right before a community outing.

Skills covered: deciding between an incident and a near miss; telling a supervisor what happened; filling out a workplace form; writing what, where, when, and who in full sentences; signing and dating a form.

Part of the Functional Life Skills series: every set uses the same layout (words, real looking documents, two levels of the same questions, and a real life task), so students know the routine when you move to the next set.

Who it is for: high school life skills and special education classes, transition programs for ages 18 to 21, and adult education. Grades 9 to 12 and adult transition.

What you download: one printable PDF, 14 pages, US Letter. Answer key included.

Made by Jeremy D. Gooch, special education teacher and transition coordinator. Drafting and layout had AI assistance; every page was checked by me.