Minnesota Department of Labor and Industry

Workplace Safety Consultation Services

The information you provide will help Minnesota Workplace Safety Consultation improve its safety services for our state's workplaces. Your responses are anonymous and will be used by the Department for program evaluation purposes only.
 
1. What was the month and year of your Workplace Safety Consultation visit?
 
2. What industry type best fits your organization?
Construction
Health Care
Manufacturing
Trade, Transportation, Utilities
Public Sector (except health care)
Other 
 
3. What is your workplace safety responsibility?
Manager/owner
Safety officer
Safety committee member
Other 
 
4. How would you rate your organization's safety system and programs?
 
5. How did you first learn about Workplace Safety Consultation services?
Business acquaintance
Trade association or conference
Internet
Other 
 
6. What was the primary reason you asked for a consultation?
Reduce injury and illness costs
Your organization is in a high-hazard industry
Prevent future injuries
Safety grant
Safety committee organization or training
Assess safety management effectiveness
Other 
 
7. If you selected Safety Grant in question 6, did you receive a safety grant?
Yes
No
 
8. If you answered Yes to question 7, how was the safety grant used to reduce or prevent hazard exposures?
 
9. What type of consultation visit did you receive?
Health
Safety
Other 
 
10. Was the Consultant knowledgable about your industry and the processes you use?
Yes
No
 
11. Did the Consultant identify hazards that affect employee safety or health?
Yes
No
Not applicable
 
12. In your opinion, as a result of the consultation services provided, has your workplace become safer for your employees?
No safer
Small safety improvements to the workplace
Moderate safety improvements to the workplace
Much safer
 
13. Did the safety consultation process and results meet your needs and expectations?
Yes
No
 
14. The length of time from your consultation request to when the consultation took place was:
 
15. The length of time from your consultation visit to receipt of the consultation report was:
 
16. What other services could Workplace Safety Consultation provide for your workplace? Select one or more items.
Workplace safety and/or health training
Evaluate safety equipment or processes
Ergonomics evaluation
Safety committee organization and effectiveness
OSHA recordkeeping training
Safety grant equipment purchases or training
Workplace violence prevention assessment or training
Other 
 
17. Please provide any additional comments about your experience with Workplace Safety Consultation.

Minnesota Department of Labor and Industry
443 Lafayette Road N., St. Paul, MN  55155
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