An employee health and safety policy questionnaire is given by a company to its staff members to set up health and safety standards, and determine what steps can be taken to safeguard the health and safety of the employees of an organization. Through this survey, the company can minimise occupational hazards and create a safe work environment.

Sample Employee Health and Safety Questionnaire:

Name of company: _______________________

Address: ___________

Phone Number: ________________

1)   Are you aware of the government legislation that oversees employee health and safety?

a)   Yes

b)   No

2)   Do you have an effective policy for you employees that is appropriate for their health and safety?

a)   Yes

b)   No

3)   If no, why not? Give reasons. __________

4)   Are your employees aware of such a policy about their health and safety?

a)   Yes

b)   No

5)   Is there a person or a department that looks into matters of employee health and safety? Please give details ________

6)   Are your employees actively involved in matters related to health and safety?

a)   Yes

b)   No

c)   Can’t say

7)   Is there any health and safety risks faced by your company? If yes, please give details of those risks. ________

8)   How often do you conduct health checkups on your employees for communicable or chronic diseases?

a)   Once a year

b)   Twice a year

c)   Never

9)   Do your employees know about the ideal health and safety practices? _____

10)               Do you hold health and safety sensitisation programmes for your employees to create more awareness? _________