Required |
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| Required | |
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Required | |
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| Required | |
Required | |
| Required | |
What was your participation in the event? | Required | |
Required | |
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Required | |
Have you been involved in a similar event? | Required | |
Do you think this will happen again? |
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Required | |
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Would you like someone from the safety team to follow-up with you? | Required | |
Would you be willing to present this Near Miss at a training session or in a safety bulletin? | Required | |
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