Workplace First Aid Needs Assessment Form
Assess your workplace's first aid needs to ensure safety and compliance. Please answer the following questions about your organization.
What type of workplace is this?
*
Office
Warehouse
Manufacturing/Industrial
Retail
Construction Site
Other
How many employees are regularly present at this location?
*
Please Select
1-5
6-20
21-50
51-100
101+
What is the general risk level of your workplace?
*
Low (e.g., office)
Medium (e.g., retail, warehouse)
High (e.g., construction, manufacturing)
How would you rate the adequacy of your current first aid provisions?
*
1
2
3
4
5
Do you have trained first aiders on site?
*
Yes, always present
Yes, but not always present
No
How confident are staff in responding to first aid situations?
*
Not confident
1
2
3
4
Very confident
5
1 is Not confident, 5 is Very confident
Please indicate the number of first aid kits and AEDs currently available:
*
Rows
Number available
First Aid Kits
AEDs
Have there been any workplace incidents in the past 12 months requiring first aid?
*
Yes
No
Not sure
If yes, please briefly describe the types of incidents (optional):
Is there anything else you'd like us to know about your workplace first aid needs?
Submit Assessment
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