Workplace Health and Safety Survey (DSG-ProF001)

  • Workplace Health and Safety Survey

    (DSG-ProF001)
    • TAP for helpful instructions and guidance 

    • Thank you for taking part in this Workplace Health & Safety Survey.

      Your honest input helps identify risks, strengthen safety culture, and guide improvements that protect everyone. This guide explains what each section of the survey is asking and how to complete it quickly and accurately.

      Before You Begin

      • The survey takes 5–10 minutes to complete.
      • Most questions are multiple‑choice with optional comment boxes.
      • There are no right or wrong answers — this survey captures your experience and perceptions.
      • Your responses may be shared in summary form with your employer depending on survey-delivery arrangements.
      • Optional personal information (name/email) is used only for:
        • Sending you a copy of your submission
        • (If you consent) adding you to the DSG Safety‑Fix mailing list

      Tips for Completing the Survey

      • Be honest -- you answers highlight real risk and opportunities.
      • If you don't know an answer, sellect th option that best matches your experience.
      • If something doesn't apply, feel free to skip optional questions.
      • When describing hazards, keep it simple and practical (e.g. "unguarded machine," "heavy lifting," "slippery floors").

      Every answer contributes to a safer workplace.

      SECTION-BY-SECTION INSTRUCTIONS

      1. General Information: This section helps identify you and your workplace context.
      2. Workplace Safety Perception: This page asks you about your general feeling of safety.
      3. Hazard Identification: This section focuses on the ability to identify hazards, by asking you to identify the most significan hazard you see at work.  There are no wrong answers -- your perspective is valuable.
      4. Injury Potential & Risk: This section looks at past injuries and anticipated risks.  You'll be asked to describe the most severe accident you believe could happen. And, how to best prevent it from happening and reducing risk(s).
      5. Safety Culture & System Assessment: This section queries your perceptions about; your own safety abilities and the safety ability of others in your workplace, your ability to raise concerns and general knowledge on workplace safety rules.  The section will also ask you about your experiences with OHS-inspectors.
      6. Summary: At the end you'll have the opportunity to review a summary of your inputs, choose if you want the summary emailed to you and add any additional comments.

      We're here to help!

      Work safe. Stay healthy!
      DSG-Pro Services | DeBoer Safety Group

      info@deboersafetygroup.com | 1-888-541-1142

    • Instructions - END 
    • General Information

      General Information

      You and your workplace, please complete all required questions.
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  • Workplace Safety Perception

    Workplace Safety Perception

    One measure of safety is PERCEPTION. How safe is your workplace ... what does your 'gut' tell you?
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  • Hazard Identification

    Hazard Identification

    Another measure of safety is the ABILITY to identify the hazards that would put workplace safety at risk.
  • Injury Potential

    Injury Potential

    Another measure of safety is the ability to REFLECT on our experiences and ANTICIPATE future risks of injury.
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  • Safety Culture & System Assessment

    Safety Culture & System Assessment

    The following questions help assess the current state of safety management and workplace culture — both within your specific location and, more broadly, within your industry.
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  • Review Your Survey Submission

    Review Your Survey Submission

    Your responses help improve hazard identification, controls and training, opportunities for injury prevention. Your participation contributes to a safer workplace!

  •  {form_title} SUMMARY

    Your Safety Perception (Today): You've evaluated your workplace as
    {rankHow}/5 {safetyranking}
    Your #1 Hazard:
    • Hazard Type: {11Please}
    • Hazard Detail: {1What}
    Your #1 hazard control recommendation:

    {13What}
    Your #1 Source of Injury (at work):
    • Hazard Type: {21Please}
    • Hazard Detail: {2What}
    • Risk level: {riskRanking}
    Your injury control recommendation:

    {23What}
    Next best steps:

    As you reflect on the hazards you've identified and the control recommendations that you've provided--please consider raising them with your supervisor/manager this week. 

    Your participation in health and safety matters - take the opportunity to make your workplace even safer!

     

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