WorkSafe Health and Safety Survey

Information including personal stories and case studies can be a powerful way of getting out our message about the importance of work health and safety. Your responses will be treated as confidential, unless you give permission otherwise.

Regarding your experience with work injury or fatality, which of the following best describes you?

I have been injured at work

I have not been injured at work, but I have witnessed or have some direct experience of a work injury

I have witnessed or been affected by a fatality at work

I have not had much direct experience of work injury or fatality

First Name

Last Name

Mobile phone (optional)

Send me email updates

Send me text messages

Address (Street, City, State, Postal code)

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