Safety Leading Indicator Tracking Form (Download)

In an ever-evolving world, safety in the workplace has become more than just an idea; it’s become a day to day operating reality. Measuring indicators and reacting to calls for improvement is essential in today’s world if a business succeeds. And so, the safety leading indicator facilitates this purpose.

The Safety Leading Indicator Form provides an organization with the means to record and track potential leading safety concerns. The vital information recorded plays a crucial role in incident prevention in the workplace.

Tracking the metrics provided by an organized safety program allows organizations like yours to make positive determinations for a safer working environment. Using safety leading indicator data to improve workplace safety and implemented procedures is a goal of any safety-conscious company. And so, without further to do, we bring you the form your business needs for tracking leading safety concerns, near misses, and more.

The Safety Leading Indicator Form

Included In The Safety Leading Indicator Form

The safety leading indicator form includes four primary sections for your staff to complete. The first section of the document details the administrative data required. It consists of the report writer’s information, date, time, location, and the general type of safety incident reported.

Following the administrative section is another checkbox section where the reporter may note the type of safety concern. And again, there are several of the most common concerns and a place for the reporter to note if other items not included in the common concerns area are required.

In the third and fourth sections of the safety leading indicator form, the reporter may describe the potential incident or threat in detail. As well, the reporter has an area on the form to include recommended preventive actions.

Image by mohamed Hassan from Pixabay

How To Use The Safety Leading Indicator Form

The idea with the safety leading indicator form is simple: record potential hazards or incidents to track and prevent. Here are a few easy to follow steps to put this form into place in your company safety program.

  1. Download and print the Safety Leading Indicator Form
  2. Provide copies of the form to your company safety representative and other appropriate personnel.
  3. Train your staff to note any potential issues that could cause a hazard or incident.
  4. Receive completed forms and apply the necessary preventive measures.
  5. File your safety leading indicator form for future analysis.

Adding Value To Your Safety Program

Every company that has a proactive approach to safety will benefit from the addition of safety leading indicators. There are multiple benefits to using indicators to track your companies workplace health and safety risk.

  • Prevent injuries and illnesses in the workplace
  • Prevent costly downtime
  • Reduce potential related expenses
  • Improve worker confidence and productivity
  • Improve company processes, procedures, facility, and even equipment

The primary concern with any company is the prevention of harm to people, be it staff or the general public. When tracking incidents and safety concerns, utilizing leading indicators benefits the company by isolating hazards before a costly or even a dangerous event.

Improving worker confidence by supporting proactive measures to make a safer workplace benefits employers by producing more efficient staff. Staff who feel comfortable and safe will be more confident by nature and thus more productive.

While incidents may provide us with great insight for our lagging indicators, safety leading indicators allow us to act preemptively. A company’s savings from preventing incidents alone show that a robust health and safety program is useful and necessary. It might be hard to see the cost savings without seeing the costs of an incident first. Let’s take a look at some of those costs.

US Work Injury Costs (2018)

  • Nationwide $170.8 Billion
  • Per Worker $1,100
  • Per Death $1,190,000
  • Per Medically Consulted Injury $41,000


These numbers show us the cost across the United States in 2018 for all work injuries was nearly 171 billion dollars. The cost per worker includes the goods/services each worker did to offset the cost. It is not average. The per death cost includes all lost wages, admin fees, and other expenses. The courts likely determined the cost to the actual businesses in many of these cases, and it would not have been lenient.

Safety Leading Indicator Tracking Tips

We recommend a few things to help you track and improve your health and safety program for optimal results. First and foremost, there is an essential fact that many companies fail to keep in mind:

Health and safety start at the top but shouldn’t end at the bottom.

The first to buy in have to be top management, but similarly, every employee must be made aware that taking part benefits all. Often in the workplace, staff may feel they should not report safety concerns for fear of retribution. Managers must train staff to embrace a safety culture that is supportive and understanding. Worker participation is the key to preventive action.

Track multiple indicators.

The purpose of safety leading indicators is more than just finding potential issues and resolving them. By tracking multiple safety indicators, patterns may begin to emerge over time that can give insight into why certain occurrences happen at frequency. Through data analysis, companies may find that they can counter specific patterns with predictive patterned behaviors and processes.

App Reporting Solution – An Alternative To Printed Forms

Any company with an ambitious staff may find that the daunting task is not correcting safety concerns; it’s organizing all the paperwork. The form we’ve provided is an excellent tool to use if your business only has only one or two forms to complete per year. However, for most businesses who want to stop printing, a digital solution is more appropriate. Let me tell you about 1ST!

Benefits Of The 1ST Reporting App Solution

Using a platform in place of printed reports and forms is the future of health and safety. We can preserve our environment each time we say no to printing unnecessarily. And that’s just the tip of the iceberg.

Upload multimedia files – Add photos, video, or audio to your report quickly and efficiently

Easy to use interface – The 1st Incident Reporting App interface is clean and has an intuitive design. Its straightforward functionality makes reporting fast and efficient.

Customizable reports and forms – Adding another field or other customization is a blessing when you want a specific form set up for your business.

Automated filing and retrieval – No filing cabinet required. With the manager’s dashboard, reports and forms can be retrieved and managed with ease.

Instant notifications – Here’s something your filing cabinet can’t do yet – send you a customized notification, something easily set up with 1st.


Start reporting today

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