Environmental Health and Safety Engagement Survey Form
Please provide your feedback on environmental health and safety awareness, participation, training, reporting habits, and improvement ideas. Your responses help us create a safer workplace.
How aware are you of our company's environmental health and safety policies?
*
Not aware at all
1
2
3
4
Extremely aware
5
1 is Not aware at all, 5 is Extremely aware
How often do you participate in environmental health and safety initiatives at work?
*
Never
Rarely
Sometimes
Often
Always
Please rate the effectiveness of the environmental health and safety training you have received.
*
1
2
3
4
5
How confident are you in reporting environmental health and safety concerns or incidents?
*
Not confident
1
2
3
4
Very confident
5
1 is Not confident, 5 is Very confident
In the past year, how many environmental health and safety issues have you reported?
*
What motivates you to participate in environmental health and safety programs? (Select all that apply)
*
Personal safety
Company recognition
Team encouragement
Rewards/incentives
Sense of responsibility
Other
Please indicate your agreement with the following statements about environmental health and safety at work.
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I feel comfortable voicing safety concerns.
1
2
3
4
5
Management supports safety initiatives.
6
7
8
9
10
Safety procedures are clear and accessible.
11
12
13
14
15
How would you prefer to receive updates about environmental health and safety?
*
Email newsletter
Team meetings
Company intranet
Digital posters/displays
Other
What is the biggest barrier to participating in environmental health and safety programs?
*
Please Select
Lack of time
Lack of information
Lack of interest
No perceived benefit
Other priorities
Other
Please share any suggestions or ideas you have to improve environmental health and safety at our company.
Submit Feedback
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