Health and Safety Survey

Health and Safety Survey — Form Fields

This surveys template includes 8 fields. Evaluate employee perceptions of workplace health and safety practices and identify areas for improvement. Free to customize and use on ZenBuild.

• Which department do you work in? (dropdown selection, required) — options: Operations / Manufacturing, Warehouse / Logistics, Office / Administration, IT / Technology, Field / Remote Work, Other
• How safe do you feel in your current work environment? (rating, required)
• How effective is the organization's safety training? (rating, required)
• Have you witnessed or experienced a workplace safety incident in the past 12 months? (multiple choice, required) — options: Yes, and it was reported, Yes, but it was not reported, No
• Do you feel comfortable reporting safety concerns to management? (multiple choice, required) — options: Yes, always, Most of the time, Sometimes, No, I worry about consequences
• Which health and safety areas need the most improvement? (Select all that apply) (checkboxes, optional) — options: Emergency evacuation procedures, Personal protective equipment (PPE), Ergonomics and workstation setup, Hazardous materials handling, Mental health support, Fire safety, First aid availability
• How satisfied are you with management's responsiveness to safety concerns? (rating, required)
• Please share any additional safety concerns or suggestions for improvement. (long text, optional)