Company Name  
Contact Name     
Email Address     
Phone Number    

What does your company do?


Does you company employ more than 5 staff?
Yes
No

Does you company carry out an annual Health and Safety Audit?
Yes
No

Does you company have a complete upto date Health and Safety policy?
Yes
No

When was this Health and Safety policy last reviewed?


Does you company carry out Risk Assessments?
Yes
No

Are all of your staff trained in relevant safety training?
Yes
No

Has your company carried out a fire risk assessment in the last 12 months?
Yes
No

Do you have a Health and Safety management system?
Yes
No

Do you have a nominated Health and Safety officer with relevant training?
Yes
No