UT Health RGV
Occurrence &
Near Miss Reporting
Reporting Form
The UT Health RGV Occurrence & Near Miss reporting form serves as a mechanism for UT Health RGV employees to submit summaries of unusual or unanticipated occurrences for review. The intent of the review is to identify process improvement opportunities.
Reports are scored based on severity and probability to help rank hazards and vulnerabilities that could result in patient harm as well as to transparently decide which event or risks to study and mitigate first.
The form contains examples of scenarios that should be reported and instructions for submission.
NOTE:
- This form is not intended for reporting occurrences involving UTRGV students or employees.
- This form is not intended for submitting complaints.
- UTRGV login credentials may be required to access the reporting form.
Click on button below to download the Occurrence & Near Miss Reporting form.
Appointment Request
Online Self-Scheduling Coming Soon with Epic MyChart!
We’re excited to bring you convenient online self-scheduling through Epic MyChart, launching soon.
In the meantime, please submit the form below or call 1-833-UTRGVMD (1-833-887-4863) to make an appointment.
*If this is for a medical emergency, please call 911 or go to your nearest emergency room.
