Work Environment Survey
  • Rate your satisfaction of the following aspects of your work environment:
    (Very dissatisfied) 1 - - 2 - - 3 - - 4 - - 5 (Very satisfied)
    Comfort
    Resting areas
    Quality of food
    Equipment availability
    Maintenance of facility
  • Rate your perceived danger with the following aspects of your work environment:
    (Very dangerous) 1 - - 2 - - 3 - - 4 - - 5 (Safe)
    Lighting conditions/visibility
    Vibrations
    Noise pollution
    Radiation/thermal environment
  • What are the lighting conditions at your workplace?
  • What types of elemental hazards are you exposed to at work? Check all that apply.
  • Are there appropriate safety precautions for these hazards?
  • Please specify:
  • Have you been injured because of work?
  • Please specify:
  • Are there medical personnel on standby for such emergencies?
  • What parts of your work environment can be improved?

That's all, folks!

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