Safety Practices Survey

In order to optimize your free consultation, please complete this survey. The better we understand your business challenge, the more effective and efficient we can be in our conversation.

1. Is your OSHA recordable rate:

 
    Choose one:
    Better than average for your industry
    About average for your industry
    Worse than average for your industry

2. What is the trend of your OSHA recordable rate?

 
    Choose one:
    Getting better
    Stable
    Getting worse

3. Do you use statistical control charts to monitor trends in your incident rates and to identify special causes?

 
    Choose one:
    Yes
    No

4. What proportion of your incident investigations result in a finding of "operator error?"

 
    Choose one:
    <10%
    11 - 25%
    26 - 50%
    >50%

5. What is your estimate of the percentage of serious incidents that do not cause any injury or property damage (frequently referred to as "near miss" incidents), that are identified and investigated?

 
    Choose one:
    <25%
    26 - 50%
    51 - 75%
    >75%

6. Do you use formal surveys of employee attitudes and perceptions to analyze your safety management system?

 
    Choose one:
    Yes
    No

7. Do first line supervisors provide on-the-spot, positive recognition for a worker's safety contributions?

 
    Choose one:
    Yes
    No

8. What do you feel is the major leverage point for the improvement of your site's safety performance?

 
    Choose one:
    Improved hazard analysis
    Improved worker training
    Improved supervisor training
    Improved planning by management
    Improved worker motivation
    Improved incident investigation
    Improved manager education
    Other

9. How would you like an AdGap Research Consultant to contact you for your free consultation?

 
    Choose one:
    
    I do not wish to be contacted at this time.

In order for us to reach you for your free consultation, please list your contact information in the boxes below.

10. Name:

11. Company:

12. E-mail:

13. Phone:

14. Address:

15. Additional comments:

Thank you for participating in this survey.