Ensure work safety with a health and safety questionnaire for employees template | FREE PDF

Health and Safety Questionnaire for Employees Template

About the Health and Safety Questionnaire for Employees Template

This Health and Safety Questionnaire for Employees Template provides an easy-to-use format for employers to assess their employees’ health and safety knowledge. It covers topics such as safe working practices, hazards, and hazardous materials. Quickly identify employee knowledge gaps and provide essential health and safety training.

This Health and Safety Questionnaire for Employees Template is a comprehensive questionnaire that enables employers to assess their workplace's health and safety issues. It includes questions related to the employee's knowledge of safety regulations, working environment, potential hazards, and safety equipment. The questionnaire also provides space for employees to give feedback on their experience of the workplace and make suggestions for improvement. This template is an essential part of any workplace health and safety policy and helps employers ensure that their employees are safe and healthy.

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Safety templates
Workplace safety templates

Preview of the template

Audit

1. Does your business have a visible, signed health and safety policy and policy statement?

2. Is there a robust procedure that is used to identify, record and manage a workplace hazard?

3. Is there a documented and well known incident and injury reporting procedure?

4. Do your procedures outline the steps required to prevent and respond to significant hazards?

5. Are signed employee induction records available?

6. Have People Conducting Business or an Undertaking (PCBU) or officers or staff attended Occupational Health and Safety training courses relevant to their job requirements in the last 2 years?

7. Can you demonstrate your staff have received information on emergency responses and taken part in drillls?

8. Can you show evidence that officers/staff of your organisation know about workplace health and safety matters and are kept up-to-date with relevant information?

9. Is there a system in place that enables open communication between management and staff about workplace Health and Safety issue management?

10. If significant hazards require the use of safety equipment or Personal Protective Equipment(PPE), is there a process which demonstrates how this equipment is issued, used, renewed and maintained?

11. Can people safely enter and exit facilities without hindrance in normal working conditions and in emergencies?

12. Is there a developed emergency response plan and are people aware of the procedures?

13. Is there a system to ensure contractors get a workplace induction before they have access to a site?

14. Is access to restricted rooms and facilities adequately controlled?

15. Has your building been verified free of asbestos and other hazardous building materials?

If you answered Yes to 15/15 questions your organisation is likely to PASS an Occupational Safety and Health assessment. If you answered NO to one or more questions you are likely to FAIL an Occupational Safety and Health Assessment. By implementing these simple Health and Safety systems and processes and utilising Lumiform Lumiform to conduct your inspections and audits you will contribute to creating a safer more healthy workplace for your staff. Start today.

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This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.