Workplace Safety Survey
Hazards, near-misses, and whether people feel safe reporting them.
4 questions · 1 page · about 2 minutes to answer · fully editable after you start
The incidents you record are the tip; the near-misses nobody reports are the iceberg. This survey asks employees directly about hazards they have noticed, near-misses they did not report, and – crucially – whether reporting feels safe or career-limiting, which is the real safety culture question.
Run it anonymously twice a year and after any serious incident. The hazard write-ins become your inspection checklist, and the reporting-comfort trend tells you whether your safety culture is improving or just quieter.
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Page 1
Safety where you work
This survey asks how safe you feel at work and whether you have seen hazards that were not reported. Your answers help us find and fix problems before someone gets hurt. It takes about 2 minutes.
Q1.How safe do you feel doing your day-to-day work?*
Q2.In the last 6 months, have you seen a hazard or near-miss that was not reported?*
- No
- Yes, once
- Yes, more than once
Q3.How much do you agree?
| Disagree | Neutral | Agree | |
|---|---|---|---|
| I know how to report a safety concern | |||
| Reports are taken seriously | |||
| I can report without negative consequences | |||
| We have the right protective equipment |
Q4.Describe any hazard you think we should fix first.
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