Heat Stress Survey
Help us assess heat stress risks, symptoms, and preventive measures in your environment.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Workplace/Location
*
What is your primary role or job function?
*
Please Select
Outdoor Laborer
Indoor Worker (Non-AC)
Indoor Worker (Air-conditioned)
Supervisor/Manager
Other
How many hours per day do you typically spend working in hot conditions?
*
Less than 2 hours
2-4 hours
4-6 hours
More than 6 hours
In the past week, have you experienced any of the following symptoms while working in the heat? (Select all that apply)
*
Excessive sweating
Dizziness or lightheadedness
Muscle cramps
Nausea or vomiting
Headache
Confusion
None of the above
How often do you take the following preventive actions when working in hot conditions?
*
Rows
Drink water regularly
Take rest breaks in shade/cool areas
Wear light or breathable clothing
Use cooling devices (fans, cool towels, etc.)
Never
1
2
3
4
Rarely
5
6
7
8
Sometimes
9
10
11
12
Often
13
14
15
16
Always
17
18
19
20
Rate your overall risk of experiencing heat stress at your workplace.
*
Very Low
1
2
3
4
Very High
5
1 is Very Low, 5 is Very High
Have you ever received training on heat stress prevention?
*
Yes
No
Have you ever been diagnosed with a heat-related illness (such as heat exhaustion or heat stroke)?
*
Yes
No
Please provide any additional comments or suggestions regarding heat stress prevention in your environment.
Submit Survey
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